Selling an outpatient therapy practice in 2026 with Dan King

Selling an outpatient therapy practice in 2026: how to become “buyable” in a softer market

“Be big enough. Offer something distinct. Be in a state where a specific buyer is eager to expand.”– Dan King

Dan King, founder of Fireside Strategic, shares a clear reality check for practice owners: selling an outpatient therapy practice in 2026 is still possible, but it is no longer a free-for-all. After the post-pandemic acquisition surge, many buyers are now more cautious and more disciplined, because prior deals often underperformed against expectations. That shift changes what buyers prioritise and how owners should prepare.

The core message is that buyers haven’t disappeared; they’ve simply become more selective. Rather than paying top-of-market prices for “good enough” operations, buyers are looking for specific attributes that reduce risk and increase confidence in future cashflow. For owners, that means moving from vague readiness (“we could sell someday”) to deliberate positioning—building the fundamentals that make a practice straightforward to evaluate, operate, and grow after a transition.

First, Dan emphasises scale through profitability. As a rough baseline, practices generating around $750,000 to $1 million in profit sit in a range where professional buyers are more likely to engage. The exact number will vary by circumstances, but the principle holds: sufficient profit signals operational maturity, makes diligence more efficient, and creates room for a buyer to invest in systems without diluting returns. If your goal is selling an outpatient therapy practice in 2026, understanding this profitability threshold helps you set realistic priorities and timelines.

Second, he points to “distinct” offerings that are genuinely meaningful to an investor. Differentiation is not just a brand story—it is a structural advantage that can improve margins, widen access, or deepen referral relationships. Examples discussed include unusually strong payer contracts, well-designed training programmes (where permitted), and higher-margin service lines such as medication management, ketamine, or psychological testing. These can create a more resilient business model and a clearer growth narrative, especially when paired with strong clinical quality and consistent delivery.

Third, Dan highlights local market dynamics. Some buyers have state-specific strategies and will pursue opportunities in particular regions even when the target is below typical size thresholds. For owners, this means local intelligence matters: which buyers are active in your state, what their thesis is, and what they value operationally. Alongside that strategic lens, continue strengthening fundamentals—documentation discipline, clinician experience, referral quality, scheduling throughput, and leadership capacity—so you can capitalise when a fit appears. If you want to build longer-term optionality, use this episode as a planning prompt and pair it with practical investments in practice growth and clinical leadership.

Takeaways

• Assume buyers in 2026 will be more selective than 2021–2022; prepare for disciplined diligence and tighter underwriting.
• Track profitability with owner salary handled transparently, so your numbers are easy for a buyer to compare and trust.
• If you’re targeting a sale, aim to build toward the rough $750K–$1M profit range—or know which strategic buyer makes an exception.
• Distinct services should be investor-relevant: stronger margins, broader access, or a defensible niche that improves referral and retention.
• Map state-level buyer activity and thesis fit; selling an outpatient therapy practice in 2026 can hinge on geography.
• Build repeatable systems now (clinical operations, scheduling, documentation, QA, leadership layers) so the practice is less “owner-dependent”.