Buying a medical practice in Southwest 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 Lee, Collier, Charlotte, Sarasota and Manatee counties on the Gulf coast and Hendry, Glades and DeSoto inland: Fort Myers, Cape Coral, Naples, Bonita Springs, Punta Gorda, Port Charlotte, Sarasota, Venice, Bradenton, LaBelle, Clewiston, Moore Haven and Arcadia. The coastal economy runs on people who choose to live or spend the winter here: retirees, seasonal residents, and the construction, real estate, health care, financial and home services that follow them. Tourism, golf and boating add to it.

Inland, the economy is agricultural: sugarcane around Clewiston, citrus, cattle and vegetables, with Immokalee in Collier County a center for farm work. The building trades, pool, landscaping and pest control companies, property managers, medical and dental practices, and marine businesses tend to do well along the coast.

This is one of Florida's most seasonal markets. From roughly January through April, restaurants, shops and service companies run at full speed. Summers are slower, so look at monthly revenue, not only the yearly total. The coast has taken two major hurricanes in recent years: Ian came ashore at Cayo Costa in Lee County in September 2022, and Milton at Siesta Key in Sarasota County in October 2024. Rebuilding brought a wave of work for contractors that won't last forever, so ask how much recent revenue came from storm repairs. Insurance costs and flood zones weigh on every property.

Housing costs near the coast make hiring hard, especially around Naples. New communities east of Interstate 75 in Lee, Collier, Charlotte and Manatee keep service companies busy.