Multiples have compressed. Regulatory scrutiny has not eased. The straightforward roll-up thesis that powered the 2017 to 2022 vintage is largely played out. What replaces it is a more demanding underwriting case built on demonstrable clinical and operational improvement — the kind of case Octavo has been quietly building diligence frameworks for since 2021.
All insights
M&A
The next chapter for private equity in physician services
The MSO playbook is maturing. Investors who win the next cycle will underwrite clinical performance, not just volume.
Brief
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