Our Buyer Network
200+ Institutional Buyers.
Competing for Your Practice.
A selection of the platforms, PE-backed groups, and strategic operators in our active buyer network.
Mihama Acquisitions is the investment bank for outpatient PT, OT, and ST practice owners. We run competitive auction processes that consistently produce above-market outcomes—with full confidentiality from start to finish.
Mihama runs a two-step blind auction process that creates genuine competition among institutional buyers—the only proven method for consistently producing above-market valuations for practice owners.
We prepare your confidential information memorandum, anonymous teaser, and data room. Your identity is never revealed until an NDA is signed.
Qualified buyers conduct analysis, request management calls, and perform site visits—all after hours and entirely confidential from your staff.
Buyers submit their best and final offers simultaneously. You select the winner based on valuation, deal structure, and cultural fit.
We manage the 90–120 day diligence process, defending your EBITDA, managing clinical compliance reviews, and protecting deal terms.
Your attorneys and the buyer’s team convert the LOI into a binding Definitive Purchase Agreement. We coordinate every detail through closing day.
Capital secured, back-office handed off, and a strategic partner behind every future decision. The deal closes—and the best part begins.
A selection of the platforms, PE-backed groups, and strategic operators in our active buyer network.
After more than two years of direct negotiations with an institutional buyer that yielded no meaningful progress—despite repeated commitments to a future partnership—Hand Therapy of Wyoming engaged Mihama to run a structured process and identify a more suitable partner.
Within five weeks of launching a targeted blind auction, Mihama secured six letters of intent from qualified buyers. The seller entered exclusive due diligence shortly thereafter, ultimately closing with a best-fit strategic partner at a valuation that substantially exceeded the terms previously offered through direct negotiation.
Throughout the process, Mihama provided strategic support across organizational restructuring, SBA financing challenges, and lease reassignment logistics—while keeping the entire transaction confidential from staff and referral sources through closing day.
Mihama regularly competes in the same market as Wall Street-advised transactions—deals involving practices many times the size of those we typically represent. Our blind auction process has consistently produced multiples that are competitive with, and in many cases comparable to, those achieved in significantly larger, institutionally-backed deals. Scale is not the only path to a strong outcome. Process is.
From start to finish, Mihama was impressive to say the least. They absolutely made our dreams a reality by partnering us with the best fit for our clinics. If you choose Mihama, you will not be disappointed.— Anni Stafford, Owner · Hand Therapy of Wyoming
A sample of the practices we have represented. Every organization on this list trusted Mihama to run their process and find the right partner.
“I highly recommend anyone considering a sale to recognize that the value Mihama brings to the table far outweighs their cost. It is not even close.”— Eric Krell · Rocky Mountain Spine & Sport
In their own words — from the sellers who have been through it.
Proprietary research from Mihama's healthcare M&A practice — written to help owners make informed, confident decisions about their transition.
Most owners leave significant money on the table by going to market without optimizing their financials first. This paper details four proven restructuring strategies that Mihama uses to boost EBITDA and increase enterprise value before the auction begins.
A QoE audit is the single biggest threat to your valuation between LOI and close. This guide walks through exactly what third-party accountants examine and how Mihama defends your number through the process.
From FCA exposure and Stark Law compliance to lease assignments and corporate record hygiene — this paper maps every legal checkpoint buyers run during diligence.
Billing irregularities, supervision violations, and unlicensed aide usage are the compliance flags that give buyers leverage to reprice or walk. This paper provides a practical remediation framework.
Your top clinician is your most valuable growth asset. This paper shows how minority equity stakes, structured compensation, and vesting schedules transform key employees into committed long-term partners.
Asset deals are the dominant structure in healthcare M&A — and their tax treatment is often misunderstood by sellers until it's too late to plan. This guide explains how proceeds are allocated and what rates apply.
Every PE-backed healthcare roll-up follows a predictable arc. This paper explains where the PT sector sits on that curve and why the window for top-of-market valuations is finite.
When a buyer approaches you directly, they believe they can acquire your business below what a competitive process would establish. This paper explains the valuation gap between direct offers and auction outcomes.
Long-term capital gains deferral is one of the most powerful post-sale tools available to PT practice owners. This guide covers Opportunity Zone investments, 1031 exchanges, and structured deferral strategies.
The PT/PTA staffing model is one of the most underutilized levers for margin improvement in outpatient rehab. This paper explains how to structure teams, manage supervision ratios, and grow revenue per visit.
The proceeds from your practice sale are only the beginning. This paper walks through how compounding works on a liquidity event and what allocation strategies maximize long-term wealth.
Hospital Outpatient Department contracts offer significantly higher reimbursement rates — but come with compliance obligations most PT owners don't anticipate. This paper maps the full landscape.
Why margins are shrinking across outpatient rehab — and what operators can do to protect EBITDA before going to market. This paper identifies the rate, cost, and staffing pressures most owners underestimate.
How the IRS requires purchase price to be allocated across asset classes in an acquisition — and the significant tax impact on both buyer and seller that most practitioners underestimate.
How short-term rental real estate generates passive losses that can offset ordinary and capital gains income — a powerful but underutilized tool for PT practice owners post-sale.
A framework for allocating liquidity event proceeds across reinvestment, tax mitigation, and long-term wealth preservation — including the common mistakes sellers make in the first 12 months after close.
The questions every PT practice owner should ask before retaining M&A counsel — including red flags, fee structures, and what separates a healthcare M&A specialist from a generalist.
The difference between Medicare's 8-minute rule and the rule of 8s — and why systematic billing errors are one of the most common deal-killers identified during due diligence chart audits.
How to evaluate new clinic locations using demographic data, competitor density, referral source mapping, and payer mix analysis — the same methodology Mihama uses when advising buyers on expansion.
Compensation structures, culture signals, and equity tools that reduce clinician turnover before and after an acquisition — the single biggest operational risk buyers flag during management calls.
Strategies for securing higher reimbursement rates from commercial insurers — including the leverage points most practices never use and how payer concentration risk affects your valuation at close.
Not every deal is a full sale. This paper examines the minority equity model — how it's structured, what a fair market salary looks like alongside distributions, and how PTs use rollover equity to participate in future upside.
How dilution works in JV arrangements, what to watch for in operating agreements, and how to protect your ownership stake when a partner brings in outside capital or additional investors.
With the 2026 conversion factor at $33.40, how you structure PT/PTA teams directly determines your EBITDA. This paper covers supervision ratios, the differential payment rule, compliance exposure, and how buyers scrutinize PTA utilization during due diligence.
Most RIAs charge 1% of AUM annually — on proceeds that could compound for decades. This paper explains how to evaluate fee models, what fiduciary vs. suitability standards mean for your money, and the questions every seller should ask before signing an investment management agreement.
Passive billing behavior is one of the most common and least visible value leaks in PT practices. This paper gives owners a tactical framework to audit RCM performance, identify underperformance, and protect collection rates before going to market.
The management call is where buyers decide whether they trust you — and whether they'll hold their offer. This primer covers what buyers are listening for, how to frame your practice narrative, and the questions that almost always come up.
Your front desk determines your collection rate, patient retention, and first impression — all three of which buyers examine. This guide covers intake, insurance verification, scheduling, and the operational standards that signal a well-run practice during due diligence.
MIPS scores affect your Medicare reimbursement by up to ±9% — and poor performance is visible to buyers during due diligence. This paper explains the four performance categories, scoring benchmarks, and how to maximize your composite score before going to market.
MVA cases carry higher reimbursement than commercial insurance — but require lien agreements, state-specific rules, and billing workflows most PT practices get wrong. This paper covers how auto liens work, how to get paid, and the 2026 state-by-state rules.
Signed into law July 4, 2025, the OBBBA contains significant Medicaid and Medicare provisions affecting outpatient PT practices. This paper explains what changed, what's at risk for practice valuations, and how buyers are pricing OBBBA exposure into their offers.
State courts are increasingly unwilling to enforce broad non-competes — and what you can't enforce, buyers can't rely on post-close. This state-by-state guide covers enforceability standards, geographic and duration limits, and how to draft agreements that hold up.
Complete the form below and we'll send the document directly to your inbox.
A confidential consultation costs you nothing and commits you to nothing. You will leave with a clear picture of your valuation and what the market will pay.
Schedule a Confidential Consultation