Buying a medical practice in Orlando and Central Florida

• More than one clinician seeing patients, so the practice doesn't stop when one person leaves.
• Clean billing: claims paid on the first try, coding that holds up to review, and no open audits by Medicare or insurers.
• A mix of payers (Medicare, Medicaid plans and insurers), with no single one large enough to hurt you if it cuts rates.
• A steady base of returning patients with scheduled follow-ups.
• Referral relationships with many doctors and hospitals, not one.
• An office manager who runs the day without the physician owner.
• In-office services, like lab or imaging, that earn their keep and are set up within the referral rules.
• A records system the staff use well, with a patient portal and online scheduling.

Start with how much of the practice's collections come from the selling physician's own work, and how long they'll stay. Then hire an independent coder to audit a sample of charts: past overbilling can become a repayment demand, and how the deal is structured affects whether that debt follows you. Check every clinician against the federal exclusion list, which names people barred from Medicare and Medicaid.

Read each payer contract to see whether it can be assigned to you, and plan for a gap in cash while new enrollments and credentialing go through. If any referring doctor owns part of the practice, or the practice sends patients to labs, imaging or therapy it owns, have a health care attorney check the arrangement against federal law and Florida's Patient Self-Referral Act (section 456.053). Ask about malpractice claims and who pays for the seller's tail coverage (insurance for claims filed after a policy ends). Work out with your attorney how patient records will transfer and who will keep them.

• How much of the practice's collections come from your own visits, and how long would you like to keep practicing here?
• Which insurers make up most of your revenue, and when did you last renegotiate your rates?
• Who handles billing and coding, and has the practice had any audits or repayment requests?
• What brings in revenue besides office visits?
• How do new patients find you, and which doctors or hospitals send you the most?
• Who owns the practice today, and does it have an AHCA clinic license or rely on an exemption?
• Do your other clinicians have contracts, and are any of them planning to leave?

This region covers Orange, Seminole, Osceola, Lake, Sumter and Marion counties: Orlando, Winter Park, Kissimmee, St. Cloud, Sanford, Clermont, Leesburg, Ocala and the large retirement communities of Sumter and Lake counties. Tourism is what the area is best known for, built on the theme parks, the hotels, the vacation rental homes around Kissimmee and the Orange County Convention Center. It's far from the only business. The University of Central Florida and the military simulation and training offices near it support a technology base, and health care is a major employer.

Marion County is horse country, with thoroughbred farms around Ocala, and it has added warehouses and distribution centers along Interstate 75. Retirees in Sumter and Lake create steady demand for medical practices, home care, home maintenance and auto services. The building trades, restaurants, and companies that serve hotels and rental homes do well across the region.

Central Florida is inland, so storm surge isn't the worry it is on the coasts. Hurricanes still bring wind damage and flooding, though: Hurricane Ian flooded neighborhoods in Orange, Seminole and Osceola counties in 2022. Ask whether the business or its customers were affected.

Tourism keeps demand steadier through the year than in markets that depend on winter residents, with busy stretches around school holidays. Hotels, parks and restaurants compete hard for workers, which pushes up wages for any company that hires hourly staff. New homes have spread fast in Osceola, south Lake and southeast Orange counties and around Ocala, so check whether a company's customers are in growing areas or older ones. Traffic on Interstate 4 limits how much ground a service company can cover in a day.