Q2 isn’t in yet, but the read is already clear.
Healthcare dealmaking came back this year, but not the way the headline reads. In the first quarter, healthcare deal value climbed 50% over the same quarter in 2025 while the number of deals fell 22%. More money, fewer deals. The capital returned and went straight to the top of the market.
You can see where it went. A short list of billion-dollar platform deals carried the quarter, led by Cencora taking OneOncology at about $4.6 billion. Big checks, written for scaled, proven assets. That is not a spree. That is concentration.
What the number hides
Underneath the dollar figure, pricing got tougher, not easier. Healthcare M&A multiples compressed to 12.7x EBITDA in early 2026, down from 13.0x a year earlier and 14.9x two years before that, three straight years of decline. The private equity side was just 11% of deals and stayed disciplined about what it would pay up for. As the bankers tracking it put it, the threshold for premium valuations has risen meaningfully.
Read it together: the money is back, but it pays full price only for practices that are genuinely ready. Everything else gets a lower number or no call at all.
Where deals actually break
The gate is operations, and it is measurable. Financial distress or reimbursement variability shaped more than 40% of provider-side deals in 2025. When a buyer runs diligence now, the practice gets taken apart on quality of earnings, payer mix, charge capture, coding integrity, and how much revenue walks out the door if one or two physicians leave. A clean set moves the multiple up. A messy one ends the conversation.
What that means if you source deals
Target identification is not the constraint. Everyone pulls the same CMS files and the same vendor lists. The constraint is knowing which owners are actually in succession mode, which practices survive that diligence, and which groups are already taking calls. In a market paying premiums for readiness, the edge is reading the supply side before the rest of the market shows up.
And if you own a practice
If a sale has crossed your mind for the next 12 to 24 months, a record dollar figure does not mean a buyer is coming for you. It means the buyer who comes will underwrite you harder than they would have in 2021. Days in AR, provider concentration, lease term, payer mix, who runs the place when you are not there. Those are the lines that set your multiple now, and they take 12 to 24 months to fix, not 12 to 24 days.
One question
Reply with your specialty and your geography. If you source deals, I will tell you what the supply side looks like before we ever get on a call. If you own a practice, I will tell you what a buyer would see if they looked at you today. No pitch. Just a straight read.
Shawn
Book a call: cal.com/healthcaremai/25min
This newsletter is for informational purposes only and does not constitute investment, legal, or financial advice.