Top Lessons From Healthcare M&A Leaders: A Compilation

Zak Eisenberg is the Vice President of Merritt Healthcare Advisors, which provides investment banking services to healthcare services organizations. In his role, he manages the strategic development and execution of ASC, surgical hospital, and physician practice transactions. Zak specializes in sourcing and analyzing transactions and capital and negotiating and structuring investments. Previously, he was a Biofund Venture Analyst at New Orleans Bioinnovation Center, a biotech and life science-focused venture capital firm, and led the analysis team at a renewable energy-focused private equity firm.

Here’s a glimpse of what you’ll learn:

• [1:15] Preparing for due diligence and addressing compliance risks before selling a healthcare business
• [3:19] Macro trends driving healthcare M&A and the rise of value-based care models
• [4:50] The importance of defining strategic goals before pursuing a capital event or sale
• [6:35] How to build high-performing healthcare organizations through strategy, culture, and operations
• [7:30] Expanding care coordination to improve patient outcomes and provider collaboration

In this episode…

The healthcare industry is shaped by legal reforms, financial pressures, and a growing demand for value-based care. For entrepreneurs and physician groups, navigating this complexity requires more than just medical expertise; it demands business strategy, operational foresight, and cultural alignment. How can healthcare leaders prepare their organizations in this dynamic environment while staying true to their mission of improving patient outcomes?

Experts across the healthcare M&A space understand how to navigate deals effectively. Bart Walker emphasizes transparency in due diligence, advising healthcare businesses to identify compliance issues early to avoid costly surprises later. Zak Eisenberg encourages leaders to align every financial decision with a clear strategic purpose, viewing transactions as tools for growth rather than exits. John Nantz highlights the importance of culture and operational discipline in building sustainable healthcare organizations, while Rani Khetarpal underscores the growing opportunity in care coordination and patient navigation.

In this episode of Transaction Healthcare, Zak Eisenberg looks back on his most insightful episodes. Bart Walker, John Nantz, and Rani Khetarpal discuss how to prepare for due diligence in healthcare transactions, build high-performing organizations through strategic alignment, and expand care coordination to improve outcomes for both providers and patients.

Resources mentioned in this episode:

• Zak Eisenberg on LinkedIn
• Merritt Healthcare Advisors
• Merritt Healthcare Advisors email: contactus@merrittadvisory.com
• Bart Walker on LinkedIn
• John Nantz on LinkedIn
• Rani Khetarpal on LinkedIn

Quotable Moments:

• “We need to make sure before we go out to market that you’ve got your house in order.”
• “None of those are deal killers, or I’d say, rarely are those deal-killer-type issues.”
• “A transaction or a capital provider… is not a strategy. It’s a financial solution.”
• “It is really helping build growth. It’s helping support growth.”
• “You need folks that can advise you and help you and put people in the room.”

Action Steps:

1. Conduct a thorough compliance audit before any transaction: Identifying billing, coding, or legal issues early prevents last-minute surprises that can delay or derail deals. Proactive transparency builds trust with buyers and strengthens your negotiation position.
2. Define your long-term strategy before pursuing a sale: Understanding whether your goal is growth, partnership, or exit helps determine the right financial path. A clear vision ensures every capital decision supports your broader mission.
3. Align strategy, culture, and operations for sustainable growth: These three elements form the foundation of any high-performing healthcare organization. When they’re in sync, teams execute effectively, and patient outcomes improve.
4. Invest in care coordination and navigation programs: These functions are the glue that connect providers, patients, and systems across the care continuum. Expanding them leads to better outcomes and stronger healthcare networks.
5. Build strategic partnerships with trusted advisors: Surrounding yourself with experienced experts accelerates growth and minimizes costly missteps. Collaboration with the right partners creates momentum and long-term resilience.

Sponsor for this episode…

This episode is brought to you by Merritt Healthcare Advisors.

Merritt Healthcare Advisors is an investment bank with a unique focus on healthcare providers and their businesses.

Merritt leverages the healthcare industry expertise of its owner-operators, clinicians, investors, and advisors to develop surgical facilities that perform safe, efficient, and cost-effective procedures.

To learn more, visit https://merritthealthcare.com/.

Episode Transcript

Zak Eisenberg 0:00

Hello, and welcome to Transaction Healthcare. I’m Zak Eisenberg, Vice President at Merritt Healthcare Advisors. Merritt Healthcare Advisors is an investment bank with a unique focus on health care providers and their businesses. Transaction Healthcare is a podcast focused on addressing questions and concerns at the intersection of healthcare, transactions and business. I’m Zak Eisenberg, a partner at Merritt Healthcare Advisors, and your host for Transaction Healthcare, where I address questions and concerns at the intersection of transactions, healthcare and business. Thanks for listening to this special episode where we’ll revisit some of our favorite conversations from previous episodes. It’s brought to you by Merritt Healthcare Advisors. We’re a healthcare focused investment bank. We don’t work on anything else, mostly with provider businesses. Usually we’re working with physician entrepreneurs, helping them to raise capital or sell their business, or sometimes helping them to buy other practices or invest in other types of ancillary service lines to learn more, visit merrittadvisory.com. Now let’s take a look back at some of our favorite conversations from past episodes.

Bart Walker 1:15

There’s a few different ways to think about it for so let’s just take a case study example. Let’s say we’re hired by a client to help sell the business, or we’re on the buy side, and we’re looking at a new opportunity. The first thing we do with our clients is we sit them down and say, Look, we need to take a very hard look at the mirror and see do what we find. We need to make sure before we go out to market that you’ve got your house in order, because we know for sure whoever’s looking at buying this is going to be doing due diligence for potentially several months. They’re going to find out everything. We need to be prepared for that. We need to understand if you do have problems or challenges. For example, do you have billing and coding audits? Do you have rack audits? Do you have government investigations? Do you have ongoing litigation? You have compliance issues? Do you have real, obvious misses in your business and and that’s okay, we can deal with all of that. The things we can’t deal with are the things that we don’t know about. So it just needs to be radical candor on all parts, so that we have total visibility into what’s going on. I think sometimes clients are reluctant to tell their lawyer something, because they’ll find an issue well, I’d rather know about it and then be able to advise them on No, that’s not something we really need to worry about. Or Yes, based on the last dozen transactions we’ve done, this is absolutely going to be a focus. And we need to tell the story of not only what the problem was, but what we did to fix it, and what the total economic exposure of it is. None of those are deal killers, or I’d say, rarely are those deal killer type issues. And the sooner we know about them, the sooner we can address it and then tell the story so that we can assure buyers that this really isn’t an issue. Sometimes there are big issues, and sometimes there are deal killers, and it puts the process on hold for, I don’t know, six months or a year, depending how long it takes to straighten it out, but most of the time, we can work through it, and it doesn’t become a timing issue, it doesn’t become a pricing issue, but if we don’t know about it, we can’t really do anything.

Zak Eisenberg 3:19

There’s so much to talk about when you’re thinking about macro trends. And least for me personally, I always like to think from that perspective, thinking about economic trends and trends that are lasting for years. And I think we all know there are several within healthcare that have been going on for a long time. So the transition to capitated models value based care is not new. That’s something that has continued to accelerate. There are other trends as well, though, which I think especially with the group that we have on the line for everyone this evening, in this meeting, we can really talk about some of the tactical changes that changed in 2023 and that are changing into 2024 and I’d actually like to start with with Jeff, one of the more, I think, interesting and really sweeping changes that’s happening across the country is really a legal change at the state level. And there are a number of states that are implementing some pretty interesting changes specifically for for healthcare, and M and A, and, of course, I’m a banker, so everything, everything’s a nail when you’re a hammer, but it does impact the rest of the important work that’s happening in healthcare in terms of consolidating care and really Creating, I think, meaningful delivery platforms for for providing patients with great care and providing physicians with the ability to read value for themselves. My team always says, and I think it’s really apt. It is that you know, a transaction or a capital provider. For like beads firm, private equity or selling to a hospital and monetizing your business is not a strategy. It’s a financial solution. And a financial solution is a way to achieve a strategy, but you can achieve that strategy in other ways. You can raise debt, you can cut costs and grow organically. Many of our clients will work with for years, who eventually become a platform size. And they do it, they do it independently, but they’re implementing maybe some other type of financial solution that doesn’t include selling today, so it’s one of the first things we always discuss with with clients, and it’s one of the things I think about, because they also sat in beads position at one point. Why are you selling? The reason for selling is very important. The reason of going through a transaction or a capital event is very important. Do you have a strategy in mind, or is it a monetization? Is it more like your retirement plan, and you know, five years from now, you’re going to retire, and that’s that’s all well and good. That’s part of the natural evolution of physician practices. But it’s something important to ask yourself, is, you know, I think especially to bede’s point, hedge funds and private equity and venture capital kind of all get lumped into this private equity bucket. And it’s a real buzzword right now with physicians, it’s not a strategy. Not all private equity firms are created equal.

John Nantz 6:35

The way that I would think about this is, is like what we’re talking about, the strategy, the culture, the operations. There’s more to say, but let’s just leave it at those three for now are like the fundamental building blocks of growing a high performing organization over time. So most investors, although not all, shockingly, but I would say most, are cognizant of these and so when they buy a company, you know, like the larger companies I work for, like they have values, right? They figure that out. It’s on their walls, right? It’s part of their onboarding process. They have a company day, right? That’s one thing you get with scale. You get that type of standardization, right? And the reason for that is because it is really helping build growth. It’s helping support growth. So among investors, it’s really common. Among physician owned groups, it’s not it’s really uncommon.

Rani Khetarpal 7:30

And I do think that there is a lot of opportunity in that to drive patient outcomes. I think it’s the glue in our healthcare continuum, care continuum, that is not, it’s kind of, it’s up until now. I think in recent times, it’s becoming a focus, but up until now, it’s kind of like a side act, right? You’ve got all this other stuff. And, oh yeah, here’s a care coordinator and a navigator. A lot of people don’t even know what navigators do, right? And I and I think there’s just this wonderful opportunity to bring this forward in a way that that window has not been present before, and so capitalizing on the momentum that the Biden administration started, and carrying that forward, I think was, was a really unique opportunity, and I wanted to do it again. Zak, I think that, again, I mentioned it before. I made a lot of mistakes the first time around, and, you know, a lot of what ifs, what if I did this? What if I chose that path? What if I did that differently, right? What if I made this different? You know, would I still be, would we be in a different spot with GTC? Not that it was an unsuccessful venture, but could we have been even bigger, and could I have impacted more people, right? And I think that this gives me an opportunity to say I could do this differently, and it’s a very similar space in a lot of ways, but much more focused, much more refined. And I think the time is right. I think we were a little ahead of our time with GTC, but the time is right now, and the ability to strike strategic partnerships, and the knowledge that I have gleaned in my journey, not just in my role, but from others and from people in my network, and understanding that you know you can’t do this alone, that you need folks that can advise you and help you and put people in the room that are much smarter than you, and learn from them. And I think that that sort of that sort of angle, is a lot different than where I was, you know, 10 years ago, and I’m excited about the impact that we’re making and the momentum we have and what’s coming in the future, for not just nav point, but the impact that nav point and what we’re doing will have on on both providers as well as patients.

Outro 9:49

And that wraps up another episode of Transaction Healthcare. Hit the subscribe button to get notified when we release new conversations, and if you are someone interested in learning more about. These topics, visit us at merrittadvisory.com, or send us an email at contact us at merrittadvisory.com.