Four ways we work with PE firms, DSOs, and healthcare platforms.
Advisory Services
PE VALUE CREATION ADVISORY
What we do
Commercial due diligence is where most advisory relationships start. We evaluate clinical operations, revenue quality, payer mix, provider productivity, and growth runway — from the perspective of someone who has personally built and run these platforms. We don't just flag risks. We quantify the upside and build the playbook to capture it. Post-close, we design and support execution of 100-day value creation plans that translate PE investment theses into clinician-actionable KPIs. We build EBITDA acceleration playbooks, provider compensation models, and operational benchmarking systems that the clinical team actually follows — because they were designed by a clinician.
Typical engagements include:
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Pre-acquisition commercial diligence
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100-day value creation plan design
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EBITDA acceleration playbook development
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Provider productivity optimization
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Payer/MCO negotiation strategy
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Portfolio company growth advisory
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Board advisory and governance
Who it's for
PE firms and family offices with existing or prospective healthcare platform investments.
Proof point:
Trusted advisor across $250M+ in sourced and closed transactions. Collaborated on 2 platform deals (orthopedics and primary medicine) with combined enterprise value of $72M.
DSO GROWTH STRATEGY
What we do
Growth in multi-site healthcare isn't just about adding locations. It's about building the operational infrastructure, revenue engine, and clinical talent strategy that makes each new site accretive — not dilutive. We design go-to-market strategies for new markets, de novo expansion playbooks, acquisition integration plans, and revenue optimization programs. We've done this across dental, home health, and physician services — from a single practice to 35 offices, from zero US presence to 9 signed DSO contracts in 8 months.
Engagements & Capabilities
- Go-to-market strategy
- De novo expansion planning
- Acquisition integration
Who it's for
DSOs and multi-site healthcare platforms looking to accelerate organic and inorganic growth.
RESULTS AT SCALE
At RipeGlobal, we built the US GTM engine from zero: 9 DSOs signed including Heartland Dental, Delivering $6.4M in annualized revenue impact in just 8 months.
- Revenue optimization
- Payer negotiations
- Clinical talent acquisition
TURNAROUND & REPOSITIONING
What We Do
We've walked into two platforms in decline and turned both around. The approach is the same: get to the root cause fast (it's almost never what the board thinks it is), stop the bleed, rebuild the revenue engine, and reposition for growth. We lead revenue recovery, operational restructuring, cost rationalization, provider productivity programs, payer renegotiation, and full rebrands when the market positioning has become a liability.
Typical engagements include:
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Revenue decline diagnosis and recovery plan
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Operational cost restructuring
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Provider productivity turnaround
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Payer/MCO renegotiation
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Brand repositioning and relaunch
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Cash flow stabilization
Who it's for
Underperforming healthcare platforms where revenue is declining, cash is burning, or the original thesis is at risk.
Proof point:
At dntl bar: 360% revenue growth in 7 months. At VIVA: reversed 12% YoY decline, shifted burn to EBITDA run-rate, and secured $25M in PE investment.
Proof point:
$350M+ in advised transactions through DSO Strategy. 2 platform deals (orthopedics, primary medicine) with combined $72M enterprise value.
Transaction Advisory
What We Do
Transactions in healthcare services are uniquely complex. The valuation depends on revenue quality, provider retention risk, payer concentration, and a dozen clinical-operational factors that traditional investment bankers miss. We provide commercial diligence from the operator's seat, help sellers position platforms for premium multiples, source acquisition targets through our extensive DSO and healthcare network, and advise on post-close integration strategy. Because we've been on both sides — as a founder who sold, and as an advisor who sources — we bring perspective that pure financial advisors can't.
Typical engagements include
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Commercial diligence (buy-side and sell-side)
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Platform positioning for premium valuations
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Acquisition target sourcing and evaluation
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Post-acquisition integration strategy
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Clinician-founder advisory during M&A
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MSO/DSO structuring and governance
Who it's for
Healthcare platform founders, PE firms, and strategic acquirers navigating buy-side or sell-side transactions.