Unless you’ve been living under a rock for a few months, you’ve probably heard that Congress passed sweeping tax reform for 2018.  The impacts of this legislation will be felt far and wide, but the general consensus is that the reform will be good for both companies and individuals.  If that bears out to be true, the economic outlook for the United States should be very favorable for the years to come.

But, what does is mean for the dental industry and for DSOs in particular?  Everybody’s got an opinion, so we asked some friends to share some feedback.

Here’s what they had to say…

In late February, my colleague, Diwakar Sinha, and I were able to escape the blustery weather of the east coast and enjoyed a few days in beautiful Scottsdale, AZ at the Dental Entrepreneur Organization’s (“DEO”) exclusive Executive Edge Workshop.

The event was targeted to emerging group practice owners who are on the cusp of making their first C-level (CEO, CFO, COO, etc.) hire. 

Here are a few gems from an extraordinary two days…

Last week my partner,Kevin Cumbus, and I braved the cold of Chicago to do some networking and educate ourselves at the McGuireWoods Healthcare PE Conference.  The action is fast, and education comes courtesy of a firehose.   

Here are the three main things we learned.

Key Healthcare Business and Market Trends & Opportunities:

Everyone wants to know if we’re “at the top of the overall healthcare market” as it relates to valuations.  The short answer is that nobody really knows, but the good thing is that in our world valuations are driven by earnings – not eyeballs.  2017 was phenomenal and the M&A sell side has been robust for 18-24months.  Equity markets have been strong and debt markets have been very favorable.  The great lending environment has been great for buyers using both debt and equity.

We work with clients all over the U.S. and inevitably hear comments like: “My five-location group generates about $12,000,000 in revenue.  I’d like to build it up over the next five years and sell it for $50,000,000.” 

OK…if you say so. 

Do you want to borrow $49,000,000 to make that happen?  I kinda doubt it.

What do you care more about: the amount of the sale or the amount you put in your bank account?  If your answer is the latter, then you need to pay more attention to the amount of debt you take on and the impact that the tax rate will play because both of those will be paid off before the sale proceeds are deposited into your account.

Wisdom & Wandering from the Herd

Last fall, my partners and I all attended the McGuireWoods Healthcare Private Equity Conference here in Charlotte.  While most of the southeast was still battling the remnants of what was Hurricane Irma, we had an opportunity to listen to sector experts as they tried to navigate the swirling winds of the healthcare industry.  Make no mistake – healthcare is hot.  There is a lot of opportunity, but it doesn’t come without an equal amount of risk.

Here’s what we learned…

We have had the honor of speaking at many conferences this year and have fielded too many questions to count.  Having said that, one particular question seems to come up with great frequency among those who own group practices:

“What’s the difference if I’m an S, C or LLC as it relates to the tax impact of selling my business?”

Well, we’ve also closed several deals recently (and have several others in the works) where the corporate election will have a major tax impact on the outcome of the deal.  There are structural considerations of the transaction that can offset some – not all – of the tax impact, but make no mistake – corporate entity election swings major dollars at the closing table. 

Doubtfully, but the Dentist Entrepreneur Organization led by Dr. Marc Cooper and CEO Jacob Puhl recently created a similar experience – and let me assure you, it was an EXPERIENCE – for four of their lucky members.

Are DSOs really going to take over the practice of dentistry? 

No, but there are a number of legitimate reasons why they've become so incredibly popular over the last several years.  We've been asked to speak to numerous groups of people over the last year and all of them - regardless of whether they were dentists, industry consultants, sales professionals or clinical professionals - have had the same questions:

• How did all of this start?
• What are the reasons behind it?
• Why is everyone so interested in forming a group or DSO?
• And, most importantly, do I want to get involved in it? 

Wisdom & Wandering from the Herd

Last fall, my partners and I all attended the McGuireWoods Healthcare Private Equity Conference here in Charlotte.  While most of the southeast was still battling the remnants of what was Hurricane Irma, we had an opportunity to listen to sector experts as they tried to navigate the swirling winds of the healthcare industry.  Make no mistake – healthcare is hot.  There is a lot of opportunity, but it doesn’t come without an equal amount of risk.

Here’s what we learned…

“The day before something is a breakthrough, it's a crazy idea.” ~Peter Diamandis 

Today we're excited to announce the official launch of the TUSK Partners website.  

TUSK Partners provides Buy-Side and Sell-Side Advisory Services, Strategic Consulting and Capital Raising Alternatives to Middle Market Dental Groups and DSOs.  We are passionate about working with transformative businesses and the management teams who drive their growth.  We build long-term relationships focused on maximizing shareholder value.   

You can download more details about our service offering here.