Current Market Range (2024-2025): The median EBITDA multiple is 13.0x from the 33 transactions over the 2-year period for physician practices generally, though Emergency Medicine companies typically trade at different ranges based on size and performance.
Size-Based Valuation Ranges:
For physician practices broadly (which includes Emergency Medicine):
- $1-3M EBITDA: 5.6x multiple
- $3-5M EBITDA: 7.1x multiple
- $5-10M EBITDA: 8.8x multiple
Market Context:
Emergency Medicine is a significant target for private equity acquisition. Emergency medicine represented 12.1% of physician practice acquisitions from 2013-2016, making it one of the most commonly acquired specialties alongside anesthesiology and multi-specialty practices.
Historical Perspective:
The major Emergency Medicine staffing companies provide context for valuations in this space:
- TeamHealth: Was acquired by Blackstone for $6.1 billion in 2016 at $43.50 per share, with the company generating $4.4 billion in revenue and $530 million in adjusted EBITDA (implying approximately 11.5x EBITDA multiple)
- Envision Healthcare/EmCare: KKR acquired the company for $9.9 billion in 2018, though the company later filed for bankruptcy in 2023 due to challenges from the No Surprises Act
Current Market Trends:
Due to the high-cost debt environment, private transaction multiples have decreased by one to two-plus turns of EBITDA suggesting current multiples may be lower than historical peaks. Buyers are being more discerning on the financial performance for selling practices and are evaluating reported EBITDA with higher scrutiny.
Bottom Line: Emergency Medicine practice management companies currently trade at EBITDA multiples ranging from approximately 6x-13x, with larger, more established companies commanding higher multiples. The sector faces headwinds from regulatory changes like the No Surprises Act, which has compressed multiples compared to historical levels when surprise billing was more prevalent.