Transactions require
an operating partner,
not just a broker.
Buy-side acquisition campaigning, sell-side positioning, recapitalization, and senior debt refinancing — built on proprietary data intelligence and operator-level diligence. Healthcare-focused. Texas-rooted. Nationally capable.
M&A without operational intelligence is guesswork.
Most M&A advisory begins and ends with financial statements. We start there too — but we go deeper. The operational diligence that surfaces revenue cycle inefficiency, payer mix misalignment, and staffing model dysfunction before a transaction closes is what separates value creation from post-close surprise.
Whether you're acquiring, recapitalizing, refinancing, or positioning for exit, the analytical infrastructure we build is the same infrastructure that institutional capital expects to see. Clean financials are baseline. Specific deployment plans, market data supporting the thesis, and a clear path to return on invested capital are what move deals forward.
Three ways we work
the transaction side.
Buy-Side Advisory
For strategics seeking to expand through acquisition. We don't wait for deals to appear — we run focused acquisition campaigns that identify targets fitting the thesis, build the financial models that justify the investment, and conduct operational diligence that surfaces risk before the LOI.
- Focused acquisition campaigning
- Target identification & screening
- Operational due diligence
- Financial modeling & deal structuring
- Post-close integration planning
Sell-Side & Recapitalization
For practices exploring exit, partial sale, or growth capital without full liquidity. We prepare the business the way a sophisticated capital partner expects to find it — then position the narrative for the right buyer or investor audience.
- Practice positioning & market narrative
- Financial preparation & cleanup
- Investor materials & data rooms
- Buyer/investor identification
- Use-of-funds architecture
- Capital deployment planning
Senior Debt Refinancing
For organizations with existing lender relationships that need restructuring, expansion capital through refinancing, or improved terms. We build the case, model the scenarios, and manage the lender conversation from term sheet through close.
- Existing debt structure analysis
- Refinancing opportunity assessment
- Lender presentation & narrative
- Term sheet negotiation support
- Capital deployment roadmap
How an engagement works.
Every transaction is different, but the analytical rigor is the same. We adapt scope and timeline to the deal, not the other way around.
Scoping & Engagement
We assess the opportunity, define the thesis, and structure the engagement — fee model, timeline, deliverables, and decision gates.
Data Intelligence & Diligence
Proprietary data stacking across CMS, NPI, census, payer mix, and lease comparables. Financial modeling, market sizing, and operational assessment built from primary sources.
Narrative & Materials
Investor-ready materials, lender presentations, management decks, and data room preparation. The story that moves the transaction forward.
Execution & Close
Active transaction management through term sheet, diligence, negotiation, and closing. We stay in the deal, not above it.
Post-Transaction Support
Integration planning, operational improvement roadmap, and ongoing advisory. M&A advisory that doesn't end when the wire clears.
Who this is for.
Healthcare organizations with $3M+ annual revenue. Specific growth thesis with identifiable targets or clear capital deployment plan. Organized financial records. Direct access to decision-makers.
Minimum deal size: $5M. Texas-focused for operating company engagements, national for PE-sponsored platforms and referral relationships.
Multi-Clinic Primary Care Platforms
Buy-and-build strategies, add-on acquisitions, and recapitalization for growth capital.
Multi-Site Specialty Groups
Dental, behavioral health, dermatology, and other specialty platforms seeking expansion or capital partners.
PE-Backed Healthcare Portfolio Companies
Operational due diligence, value creation thesis, and post-acquisition roadmaps for middle-market PE firms.
Practices Seeking Senior Debt Restructuring
Refinancing existing obligations, unlocking expansion capital, or improving terms on existing lending relationships.
Before the
engagement letter.
How is Axiom's M&A advisory different from a traditional broker?
We're operators first. Where a broker matches buyers and sellers, we build the analytical infrastructure — proprietary data stacking, operational diligence, financial modeling — that makes the deal defensible. And we stay post-close to execute the value creation thesis, not just collect a success fee.
What does the fee structure look like?
Engagement structures vary by transaction type. Buy-side and sell-side engagements combine a monthly advisory retainer with a success fee tied to deal close. Refinancing engagements are typically retainer-based. We discuss fee structure in the initial scoping conversation — no surprises.
Do you work on deals outside of healthcare?
Healthcare is where our data advantage and operational depth are strongest. For non-healthcare transactions, we evaluate on a case-by-case basis — typically when referred by an existing relationship or when the operational complexity fits our methodology.
How long does a typical transaction take?
Refinancing engagements can close in 60–90 days. Buy-side campaigns typically run 4–9 months from kickoff to close. Sell-side positioning and recapitalization timelines depend on market conditions and buyer/investor appetite, but 6–12 months is common.
Every transaction starts
with a thesis.
Whether you're acquiring, recapitalizing, refinancing, or exploring options — we scope the engagement around your specific situation, timeline, and objectives.
Schedule Your Consultation →