Selling or buying a site or practice, with an independent read.
Sell-side preparation, buy-side sourcing, valuation readiness, and operational diligence for clinical research sites and physician practices.
physicians became employees of hospitals or corporations between 2018 and 2026.
PAI and Avalere, 2026of U.S. medical practices are still physician-owned.
PAI and Avalere, 2026of rural physicians now work for hospitals or corporate entities.
PAI and Avalere, 2026growth in employed physicians from 2024 to 2026 alone.
PAI and Avalere, 2026The independent practice is becoming rare
Share of U.S. physicians employed by hospitals, health systems, or corporate entities such as private equity and insurers.
Source: Physicians Advocacy Institute and Avalere Health, physician employment studies, 2022 to 2026
Who owns the practice
Share of U.S. medical practices owned by hospitals, health systems, or corporate entities.
Source: Physicians Advocacy Institute and Avalere Health
Who is buying practices
Physician practices acquired in 2024 and 2025.
Source: Physicians Advocacy Institute and Avalere Health
Where enrolled patients actually come from
In an analysis of 173 cancer trials, a small group of sites carried most of the enrollment.
Source: Phesi, site-level enrollment analysis
Four ways we advise.
For owners preparing to sell, buyers building platforms, and the companies selling into both.
Sell-side preparation
Research sites and physician practices readied for sale: operating data organized, value drivers documented, and first-offer terms tested against the market.
Buy-side sourcing
Sites and practices identified and introduced to buyers building networks, with fit assessed before the first meeting.
Valuation readiness
The numbers a buyer will ask for, assembled before they ask: enrollment by investigator, payer mix, provider retention, and revenue by service line.
Operational diligence
Who is actually producing, whether they stay after close, and what the operating data reflects under closer examination.
Owners, buyers, and the companies selling to them.
An approach usually arrives as a term sheet, a data request, and a timeline, negotiated against a counterparty that completes these transactions every quarter.
- 01For ownersSites and practices prepared so the first offer is not the only offer.
- 02For buyersPlatforms sourced, introduced, and diligenced on who actually produces.
- 03For companiesGo-to-market advice on how site and practice purchasing decisions are made.
Buyers price what they can verify.Northstra Health advisory
What buyers look at.
The questions a serious buyer asks, and the ones an owner should answer first.
Clinical research sites
- Enrollment history by study, sponsor, and investigator
- Sponsor and CRO mix, and repeat business
- Principal investigator retention after close
- Active study pipeline and feasibility win rate
- SOPs, monitoring findings, and audit history
Medical practices and medspas
- Revenue by service line and payer mix
- Provider retention and compensation structure
- Patient volume and new-patient trends
- Leases, vendor contracts, and pharmacy relationships
- Licensing, compliance, and documentation
How a sale runs
The stages we plan against when an owner is preparing to sell.
Timelines are typical ranges and vary by asset, buyer, and structure.
From our advisory practice.
How we think about value and independence.
What an enrollment number hides in diligence.
A network's enrollment often rests on a small group of high-performing sites and investigators. Diligence has to find out who is actually producing and whether they stay after close.
Independence is now the scarce asset.
Physician-owned practices are now the minority, and there are fewer every year. Owners who stayed independent hold something buyers want, and the time to prepare is before the first call.
Northstra Health provides strategic and operational advisory. We are not a registered broker-dealer and do not effect securities transactions. The terms of each engagement are set out in writing.
An independent read before you sign.
Whether you are preparing to sell, evaluating an acquisition, or selling into the market, start with a conversation.