By: Steve Kikikis, VP of Commercial Healthcare Real Estate, OMNI Practice Group
A hot topic in nearly every meeting we have with sellers that have multi-DVM practices, is what is corporate buyers are paying for clinics these days.
The most common valuation figure in circulation among practice owners today is a 2021 number. It reached them through a colleague who sold at the peak, or secondhand from someone who did, and it is frequently off by several turns of EBITDA. Retirement plans should not be built on that narrative.
This paper sets out what corporate buyers have actually paid for veterinary practices over the past decade. The headline is not the level. It is the volatility. Multiples tripled in six years, gave back forty percent in three, and have partially recovered since. An owner who plans around a single point on that curve is planning around an accident of timing.
The Decade That Reset Expectations
A decade ago, a healthy companion animal hospital sold for three to five times EBITDA. Consolidators changed that arithmetic. As private equity moved in, competition for good hospitals pushed the median into the six-to-ten range and then straight through it.
2021 was the top. Zero interest rates met a pandemic surge in pet ownership, and practices cleared at twelve to eighteen times. Omni flagged at the time that the level would not hold. That was not a difficult call — capital was demonstrably cheaper than the underlying fundamentals justified.
The unwind was faster than the climb. The Federal Reserve added 525 basis points between March 2022 and July 2023, and the entire sector repriced.
By 2023 we were back to eight to twelve times, which is roughly where the market sat in 2018 and 2019. Practices in the one-to-three-million EBITDA band gave up a turn and a half to two and a half from the peak. Platforms gave up two to four. Most observers identify 2024 as the bottom, which is consistent with the offers Omni saw during that period.
The recovery since has been real, but partial. We have climbed one to three turns off the 2024 lows, and quoted ranges now run roughly six to twelve depending on the practice. This is a considerably better market than 2023. It is not 2021, and Omni does not expect a return to those levels in this cycle.
The Number Behind the Number
One statistic explains most of why we have not snapped back, and it is the first input Omni examines before pricing a practice: veterinary invoice growth has been negative three years running, down more than two percent annually.
Buyers are not paying for last year’s earnings. They are paying for what they expect to make based on the practices historical numbers and what growth they can expect. When the industry-level forecast deteriorates, every practice in it gets marked down, however well an individual hospital is performing.
This is why waiting for a rate cut is not a strategy. Cheap debt was only half of what built the 2021 peak. The other half was a demand curve that has since gone flat, and rate policy does not fix that.
The Average Is Not Your Practice
If an owner takes one point from this paper, it should be this: the headline range describes a market, not a hospital. The spread inside it is wide, and it is getting wider.
A solo owner-operator producing more than half the revenue is looking at four to six times on a direct offer. That discount is not a buyer being difficult. It reflects a legitimate concern that the earnings may leave with the seller, and any disciplined buyer would underwrite it the same way.
A multi-doctor practice with diversified production and real management depth sits materially higher — call it five and a half to seven and a half on a direct offer, and better through a competitive process, closer to 10x-14x. Specialty and emergency have carried a premium of one and a half to three and a half turns over comparable general practices.
Meanwhile the consolidators themselves trade in the high teens. The Southern Veterinary Partners and Mission Veterinary Partners merger closed at seventeen to eighteen times. That gap between what a platform pays for your hospital and what it later sells the combined business for is the entire economic engine of consolidation. Sellers sit on the low side of that trade, and should price accordingly.
The Volatility Is the Finding
Most commentary on this market argues about the level — whether practices are worth nine times or eleven times today. That argument misses the more important number.
Look at the year-over-year panel. Multiples rose 36% in a single year, then fell 26% two years later. Three of the eleven years were negative. The standard deviation of annual change across the period is roughly 19 percentage points against an average of about 9. The noise is twice the signal.
A practice worth $10 million at the 2021 peak was worth $6 million by 2024. Nothing about the practice changed. Only the year did.
That is the finding an owner needs to internalize, and it cuts in two directions.
It argues against waiting for a better market. Nobody called the 2021 peak in advance, and nobody called the 2024 bottom. Owners who held out for a return to peak pricing in 2022 and 2023 watched the market move further away from them, not closer. Timing this curve is not a strategy available to a single seller with one asset.
It argues for controlling what does not swing. Owner production concentration, associate retention, wellness plan penetration and lease term move a practice within its band regardless of where the band sits. Those gains are durable. A favorable market year is not.
It also argues for treating any single comparable with suspicion. Note that the spread within a single year is itself wide — roughly six turns of EBITDA at the 2021 peak. A colleague’s sale price tells you what one buyer paid for one practice on one date. Given both the volatility between years and the spread within them, the year that sale closed and where it fell inside that year’s range carry more explanatory weight than almost anything about the practice itself.
The Uncertainties That Actually Matter
Four variables will determine where the market goes from here. None is within an owner’s control, and none has a confident answer today. Their combined range is what produces the volatility shown above.
Demand. Three straight years of negative invoice growth. Until visit counts stabilize, no amount of cheap debt restores peak pricing. This is the master variable.
The frozen exit market. This is the risk sellers understand least, and it warrants more attention than it receives. The recapitalization market for consolidators has been effectively closed since mid-2022. Apart from the SVP and MVP merger, there has been no true third-party exit for a growth-through-acquisition consolidator in four years. Western Veterinary Partners’ sponsor exited through a continuation fund — one fund selling to another fund run by the same firm, which is not the same thing as a sale. Platform valuations that ran twenty to twenty-four times in 2021 would likely clear at seventeen to nineteen today.
Here is why that lands on your kitchen table. Consolidators buy hospitals with borrowed money, expecting to sell the combined business later at a higher multiple. If they cannot exit, they cannot recycle capital, and their appetite for acquisitions falls. When consolidator valuations soften, the individual practice market follows. It always has.
Balance sheets. Several platforms are carrying debt raised in a completely different rate environment, and refinancing it costs roughly twice what the original paper did. One national group was downgraded to CCC+ in 2025 with its capital structure described as likely unsustainable. A buyer working through a balance sheet problem is not a buyer bidding aggressively, and Omni weighs this when determining which groups a listing goes to.
Regulation. New York, North Carolina, and other states have moved on corporate practice of medicine rules, constraining the management services organization structures these buyers depend on and voiding some non-competes. If that spreads, the buyer pool narrows. A narrower pool means lower multiples no matter what the Fed does.
What Omni Advises
Three principles apply to nearly every engagement.
Throw out the 2021 comparable. It overstates your value badly. A 2023 comparable understates it. This market is its own thing and has to be priced on its own terms.
Work the drivers you control. Owner production concentration, associate retention and agreements, wellness plan penetration, lease term. These move your multiple within the band far more reliably than waiting for the market to move the band. Practices with fifteen percent or better wellness enrollment consistently land at the top of their cohort, and eighteen months of deliberate work is usually enough to get there.
Competition beats timing. The gap between a single direct offer and a properly run process on the same hospital is routinely larger than the difference between a good market year and a mediocre one. A single buyer’s number is not a valuation. It is an anchor.
The sector has been through a full cycle in under a decade, and the next move is genuinely uncertain. The owners who do best are not the ones who time it — that curve cannot be timed. They are the ones who build a hospital worth buying, and go to market with more than one buyer in the room.
If you are serious about selling and wanting your to know your practices current true value, contact us today and we can discuss the details based on your unique situation.