September 28, 2026
Meta description: What do you need in place before you talk numbers with a buyer? For North Carolina owners: a financeable balance sheet, forward-looking cash analysis, and an arm's-length process.
In Practice Acquisition, “Why the FTC's Deal Crackdown Rewrites NC Exit Strategy” is now the central question for North Carolina owners weighing unsolicited interest, because the higher standard is clear: a financeable balance sheet, forward-looking cash position analysis, and a broad, arm’s-length sales process. Buyers must also prove that their capital plan supports durable patient access, operational stability, and regulatory scrutiny.
“We've had two hospital systems and a private equity group approach us this year. How do we know whether an offer is actually good, and what do we need in place before we start talking numbers?”
The answer is strategic preparation. Accounting is history. Financing is forward looking, and the right financial partner helps sellers and buyers evaluate enterprise value, liquidity, reimbursement risk, and transaction structure before negotiations begin.
Three Developments Reshaping Healthcare M&A
✅ On September 2, the FTC’s Fairfield Medical Center statement said regulators will “stop bad hospital deals” and expects sellers to run a robust, broad process.
✅ On September 21, Wake County commissioners approved the Atrium–WakeMed combination. As NC Health News reported, state and federal reviews remain ahead amid concerns about prices, competition, and access.
✅ The proposed Stop Corporate Takeovers of Physicians Act would restrict MSO control over billing, pricing, staffing, and ownership.
✅ The CMS CY 2027 proposal projects a 1.68% conversion-factor reduction for non-qualifying APM clinicians and a proposed 50% payment reduction when a same-day E/M visit is billed with modifier 25.
Build a Financeable Exit Before Discussing Price
✅ Run cash position analysis, normalize earnings, document payer concentration, and model reimbursement pressure.
✅ Establish a competitive process with equal information access and qualified advisers.
AR-Backed Working Capital for Transaction Readiness
White Coat Financial Partners provides AR-Backed Working Capital through a non-notification model. Owners retain billing and collections control; WCFP does not take possession of receivables or contact patients. Lending is based on aggregate total AR, not individual claims, with scheduled repayment aligned to cash flow rather than open-ended discount rates.
✅ Equipment leasing pays for usage rather than ownership, and lessees may deduct the full lease payment as a business expense in the year of payment (check with your tax advisor to see if you qualify). Operating leases appear as expenses on the P&L rather than liabilities on the balance sheet, preserving debt capacity; purchase options support upgrades, and leasing strengthens M&A readiness.
A Forward-Looking Partner for Both Sides
White Coat Financial Partners delivers white-glove financial planning, capital optimization, and M&A support. Start a confidential conversation or call 910-688-5077.
About the Author
Stuart D. Anderson is the founder and President of White Coat Financial Partners, a Fayetteville, NC-based firm providing specialized financial and advisory services for healthcare professionals and organizations. With deep expertise in AR-backed working capital, equipment leasing, M&A brokerage, and Lean Six Sigma process optimization, Stuart helps medical practices unlock capital, streamline operations, and achieve long-term financial stability. Connect with Stuart on LinkedIn.