Buying an outpatient clinic, lab or imaging center in Orlando and Central Florida

• Many referring doctors, with no single practice sending most of the volume.
• Contracts with the major insurers in the area at stable rates.
• Equipment in good condition, under service contracts, and recent enough that insurers and referring doctors accept the images and results.
• Current accreditations, and stable agreements with the radiologists or medical director.
• Fast scheduling, quick results, and staff who handle insurance pre-approvals well. That is often what referring offices care about most.
• For urgent care: a visible location, good hours and short waits that bring patients back.
• A billing team that tracks denied claims and appeals them instead of writing them off.

Ask for volume by referring doctor for the last two or three years. If a few practices send most of it, ask to meet them before closing. Find out whether any referring doctor owns part of the business or receives payments from it, such as rent, medical director fees or marketing deals. Have a health care attorney review each one, because federal and Florida referral laws apply.

Get the age, service history and remaining payments on every major machine, and price out replacing anything near the end of its life. Check whether equipment leases and service contracts can be assigned to you. Look at the mix of payers and recent rate changes, since Medicare and insurers revise their rates. If auto insurance claims are a large share, confirm the center has the license and accreditation that Florida's no-fault law requires for it to be paid. A licensed clinic that offers MRI must hold national accreditation, and AHCA will deny a change of ownership if the clinic is out of compliance (section 400.9935(7)), so get the accreditation file. Finally, plan the timing of licenses, enrollments and payer contracts so billing doesn't stop.

• Which doctors or practices send you the most patients, and how long have they worked with you?
• How old are your main machines, and what do the service contracts cover?
• Who reads your scans or directs the lab, and could that agreement easily continue under a new owner?
• Which insurers do you have contracts with, and have any cut rates or dropped you recently?
• How long does a patient wait for an appointment, and for results?
• Do any doctors who refer to you have an ownership stake or another financial arrangement with the business?
• Has the center had any audits, inspections or repayment requests from Medicare or insurers?

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.