The Weekly Checkup · August 18, 2026
The Weekly Checkup: Week of August 10-14, 2026
The Pulse
Quiet week after a couple busy ones. I tracked 38 announced transactions this week, with 3 platform deals, 17 services and 21 technology. Lighter on volume than last week, especially on the services side. The one deal with full financial disclosure is Teledyne's $1.1 billion take-private of Varex Imaging, a week after KKR took Integer out at 14.6x, and I've run it against the imaging comps in our database below. And DermCare and U.S. Dermatology Partners combined into one of the largest dermatology groups in the country, a platform-on-platform merger.
Listings run from another lien-based personal-injury orthopedic practice priced at 2.4x a 50% margin, to three Michigan autism clinics asking 0.6x cash flow.
🤝 Announced Deals
Deal value: $1.1 billion | EV / Revenue: 1.28x | EV / EBITDA: 9.35x
Teledyne agreed to acquire Varex Imaging, the Salt Lake City maker of X-ray tubes, digital detectors, and imaging components, for $18.90 per share in cash, roughly a 50% premium and approximately $1.1 billion in aggregate value including equity awards and net debt. Against LTM revenue of $857.9 million and adjusted EBITDA of $117.6 million, a 13.7% margin, that works out to 1.28x revenue and 9.35x EBITDA. Close is expected in early 2027 after regulatory clearances and a shareholder vote.
My take: Our imaging equipment comp set goes back to 2012, and there are five deals with derivable EBITDA multiples: Philips / Volcano at 36.3x (2015), FUJIFILM / SonoSite at 21.1x (2012), Altaris / Analogic at 13.8x (2018), discoverIE / Sens-Tech at 11.0x (2019), and Risk Capital / Xstrahl at 9.6x (2018). The median is 13.8x. Varex at 9.35x is the cheapest entry in the set, and even though Teledyne paid a roughly 50% premium to the unaffected price.
The comps above are mostly system-level businesses, and Varex is a components supplier selling tubes and detectors into imaging OEMs with a low-teens margin and China exposure. As a result, a strategic could pay a generous-looking premium while staying below every imaging deal of the past decade. Teledyne is probably most interested in Varex's photon-counting detector position, as one of the only independent sources, plus recurring replacement demand on the installed tube base.
Deal value: $820 million upfront, up to $500 million in milestones
Jazz agreed to acquire privately held Actio Biosciences for $820 million upfront plus up to $500 million in approval and sales milestones. Actio's lead asset, ABS-1230, is a first-in-class oral KCNT1 inhibitor for KCNT1+ epilepsy, an ultra-rare epileptic encephalopathy affecting roughly 2,500 U.S. patients with no FDA-approved therapy. The ongoing Phase 1b/2a KYRON study is intended as the registrational trial, and the asset carries Fast Track, Orphan Drug, and Rare Pediatric Disease designations.
My take: $820 million upfront across 2,500 addressable U.S. patients is roughly $330,000 of upfront consideration per patient, before a single approval. Rare disease valuations are usually framed this way: prevalence, realistic penetration, net price, and durability of that price, discounted for clinical and regulatory risk. Jazz clearly believes an orphan drug with no competition and a registrational path out of a Phase 1b/2a can support six-figure annual pricing for a long time, and its $935 million Chimerix deal was similar.
Actio's non-epilepsy assets are being spun out to a new private company before closing, so Jazz is only paying for what it wants while Actio's shareholders keep a second lottery ticket.
Park Dental Partners (NASDAQ: PARK), the Minneapolis-based dental resource organization, agreed to acquire the Village Family Dental DSO, a multi-specialty group founded in 1985 with 12 locations across eastern North Carolina supporting 26 general dentists and 22 specialists. The deal marks Park's fourth state. The same week, Rock Dental Brands added TLC Pediatric Dentistry & Orthodontics in Tampa.
My take: Dental shows up in this section most weeks, but the buyer here is the interesting part. Park is a publicly traded, doctor-centric DSO rather than a PE platform, and it just bought a 40-year-old, five-owner-doctor group that built its own in-house specialty referral model decades before the roll-ups discovered the strategy. When a public acquirer with a doctor-ownership story competes against sponsor-backed platforms, sellers who care about clinical governance suddenly have a differentiated bid to weigh against private equity.
One process note: the release flags North Carolina dental regulatory clearance as a closing condition. North Carolina's dental board polices management arrangements more aggressively than most states, so the management agreement between the DSO and the practice entities will get read closely. Sellers in board-active states should budget time for that review.
DermCare Management, the Hollywood, Florida practice-management company founded in 2016, completed a combination with Dallas-based U.S. Dermatology Partners, creating one of the largest dermatology groups in the country across 12 states. DermCare founder Jeffrey Schillinger becomes Executive Chair of the combined company; USDP CEO Paul Singh takes the CEO seat.
My take: When two large platforms merge with each other instead of selling to a bigger sponsor, it speaks to where a roll-up sector is in its lifecycle. Dermatology was among the first physician specialties PE consolidated at scale, USDP itself worked through a widely covered debt restructuring back in 2020, and the sector now has dozens of sponsor-backed platforms that all need exits into a market with expensive debt and no IPO window. So the platforms are merging: QualDerm and Pinnacle did it, West Dermatology and Platinum did it, and now DermCare and USDP are doing it. The combination buys scale, payer leverage, and a national clinical trials capability while deferring the exit question to a later, larger process.
Two practical consequences for readers. Dermatologist sellers just lost an independent bidder, since two potential buyers became one, and merging platforms typically slow add-on activity during integration, so expect quieter derm deal flow from these two for a few quarters. If you own a practice in their overlapping markets, the time to run a process was arguably last quarter. The next-best time is after integration settles.
CHG Healthcare, the second-largest healthcare staffing firm in the country, acquired KREWE Anesthesia, a New Orleans CRNA staffing company founded by practicing CRNAs in 2022. KREWE reports roughly 84% annual clinician retention.
My take: A company founded in 2022 just sold to the industry's number two in under four years. CRNA coverage has become the single hardest advanced-practice role to fill, hospital anesthesia subsidies keep climbing, and rural surgical programs live or die on CRNA availability. When labor is that scarce, clinician loyalty is extremely valuable, which is why CHG bought retention (84% in locums is unusual) rather than building a job board. If you own a specialty staffing business with defensible clinician retention metrics in anesthesia, radiology, or behavioral health, strategic buyers are paying up right now, and it looks like you may not need a decade of operating history to get there.
I tracked 30 additional transactions this week, including Kyndryl's purchase of Healthcare IT Leaders, Bruker's majority investment in organ-on-a-chip developer MIMETAS, and Curium's acquisition of radiopharma Abscint, which extends the nuclear medicine consolidation from the last two weeks. AMSURG added its eighth Louisiana ASC, and StrideCare added Coastal Carolina Podiatry, extending the podiatry consolidation I first flagged back in April when Upperline and UW Health both bought practices in the same week. The complete list, with the financial detail Scope is known for, is available to clients.
🏷️ Active Listings: Businesses You Can Actually Buy
Five listings, two of them autism services. The usual exercise applies: figure out what each earnings line is measuring before arguing about the multiple.
Location: Orlando, FL | Asking Price: $6.83M | Revenue: $5.62M | Cash Flow: $2.81M | CF Margin: 50% | Price / Revenue: 1.2x | Price / Cash Flow: 2.4x
Multidisciplinary orthopedic and personal-injury practice with over 40 years of continuous family ownership, three clinics across Central Florida, and vertically integrated care from diagnostics through spine, extremity, and neurological surgery, with orthopedic surgeons, a neurosurgeon, and interventional pain specialists. The revenue model is lien-based, with billing, AR, and lien administration handled in-house. FY2025 revenue of $5.62 million was a record, up 15.4% year over year, and adjusted EBITDA margins have held above 42% in each of the last three years.
My take: In commercial orthopedics, 2.4x cash flow and 1.2x revenue for a growing, 50% margin, three-clinic platform would be an obvious mispricing. In PI medicine it's an earnings-quality discount showing up in the price. Lien-based practices get paid when the underlying case settles, usually at a negotiated reduction, so accrual earnings and cash can sit years apart, realization on PI receivables commonly runs 30% to 70% of billed charges, and the AR ages on litigation timelines rather than payer cycles. The broker clearly knows where buyers will push, because the listing preempts all three objections: minimal bad debt, gross-to-net driven by settlement reductions rather than write-offs, and no significant referral-source concentration. Those three claims are the diligence agenda, in order. Get the AR aging with three-plus years of realization history, the gross-to-net waterfall, and referral volume by law firm.
If the claims survive, this gets interesting, because the structural pieces are better than most PI listings: costs held flat while revenue grew, a three-month owner transition, and a key administrator open to a one-to-two-year continuation contract, which matters because in PI medicine the administrator often holds the attorney relationships day to day. Add a Stark and AKS review on the in-house diagnostics, and structure a piece of the price against collections of the acquired AR regardless. Worth noting the spread in this niche: last week's Ohio injury practice asked 6.7x for the same model. The distance between 6.7x and 2.4x for the same species of business is a reminder that nobody really knows what lien earnings are worth until the realization history is examined closely. At this price, the buyer universe includes searchers and owner-operators, not just PI-focused MSOs.
Location: Maricopa County, AZ | Asking Price: $2.245M | Revenue: $1.37M | SDE: $582K | SDE Margin: 42% | Price / Revenue: 1.6x | Price / SDE: 3.9x
Telephone answering service with nearly 30 years of operating history. Roughly 70% of revenue comes from medical practices, hospice providers, and home health agencies, with the balance from legal and other professional clients. Per the listing, the business generated over $1.37 million of 2025 revenue on a recurring-revenue model with minimal marketing to date.
My take: This is healthcare-adjacent rather than healthcare. No clinical licensure, no CHOW process, no payer credentialing, so a close can move fast, and after-hours coverage for hospice and home health is about as mission-critical as unregulated services get. The 42% SDE margin is high for an answering service, which typically runs on thin operator labor economics, and it suggests either a lean remote workforce or premium per-account pricing that healthcare clients tolerate because switching an after-hours line is miserable. Both are good facts, but neither is verified until you see the labor model.
The 3.9x question is the one the listing won't answer: AI voice agents are coming for exactly this category, and a buyer needs a thesis. Either you believe medically sensitive after-hours triage stays human for liability and escalation reasons longer than the market thinks, or you're a technology operator buying a client base and BAA relationships to deploy automation into. The second buyer can justify the ask; the first is paying nearly 4x SDE and 1.6x revenue for a business whose core function is being replicated in software.
Location: Washoe County, NV | Asking Price: $1.7M | Revenue: $1.93M | SDE: $865K | SDE Margin: 45% | Price / Revenue: 0.88x | Price / SDE: 2.0x
Allergy and asthma specialty practice founded in 1974, under the current physician's ownership since 1995, with the owner now seeing patients two days per week ahead of retirement. Payer mix is roughly 66% commercial (including about 22% Anthem), 26% Medicare, and a declining Medicaid book closed to new patients. The listing discloses the five-year SDE trajectory: $322K in 2022, $746K in 2023, $838K in 2024, $865K in 2025.
My take: SDE went from $322K to $865K in three years, a margin move from roughly 16% to 45%, while the owner cut back to two days a week. Something changed in 2023. The good version: the practice shifted earnings onto the immunotherapy annuity, the recurring shot and serum revenue that clinical staff deliver across multi-year treatment courses, possibly with biologics buy-and-bill on top, and the owner's reduced schedule proved the income doesn't depend on him. The less good version: the jump reflects normalization choices, deferred spending, or a payer event that doesn't repeat. Get the 2022-2025 P&Ls side by side and make the seller narrate the bridge line by line.
If the good version holds, 2.0x SDE is cheap for a practice with a genuine regional moat: patients travel two to three hours, and it's the only pollen-count provider in the market, feeding local media twice a week, which is five decades of free advertising. The commercial-heavy payer mix helps too. A buyer needs an allergist or supervising structure, though Nevada's full practice authority for NPs gives more flexibility than most states, and the two-day schedule means the growth plan might just be opening the calendar.
Location: Orlando, FL | Asking Price: $3.25M | Revenue: $6.4M | Cash Flow: $940K | CF Margin: 15% | Price / Revenue: 0.51x | Price / Cash Flow: 3.5x
Behavioral health and education company operating four licensed locations, providing Medicaid-approved ABA therapy and a Medicaid-approved learning center program, with waitlists of 16 families for ABA and 22 for the learning center. The company also holds active contracts for four additional service lines it isn't currently running (psychiatry, individual and family therapy, couples therapy, telehealth) that a buyer could reactivate without new licensing. Seller offers two weeks of transition support.
My take: I walked through the autism services reset last week on the 0.28x revenue listing, and this one fits that: ABA at this scale should run high teens to twenties, and the gap usually is due to BCBA wage inflation, unbilled supervision hours, or rate mix. Diligence should compare authorized hours to delivered hours to collected dollars, verify the Florida Medicaid versus commercial split, and test whether the waitlist reflects demand or a staffing bottleneck, because 38 families you cannot hire against is not growth.
Two details from the listing deserve attention. The four dormant-but-contracted service lines are an underpriced asset if they're what the listing says they are: payer contracts without the licensing can save 12 to 18 months of effort, so confirm the contracts are active, assignable, and survive a change of ownership. And two weeks of transition support is startlingly short for a clinical business where the seller presumably holds payer, school, and referral relationships. In behavioral health I'd want a transition measured in months, not sprints, and the brevity of the offer is worth a direct question. Most likely buyer: a regional platform buying Central Florida density that can absorb the waitlist with existing recruiting.
Location: Ann Arbor, MI | Asking Price: $595.9K | Revenue: $3.37M | Cash Flow: $1.02M | CF Margin: 30% | Price / Revenue: 0.18x | Price / Cash Flow: 0.6x
Three clinics serving children and young adults up to age 20 with ABA therapy, speech therapy, occupational therapy, parent and caregiver training, case management, and mental health counseling. Furniture and fixtures included; the listing cites recurring waitlists.
My take: I checked the listing page directly because I assumed the aggregator had mangled the numbers. It hadn't. The seller is genuinely advertising $1.02 million of cash flow and asking $595,900 for it, and last week's 0.28x revenue ABA listing suddenly looks conservatively priced. Nothing in behavioral health clears at 0.6x cash flow, so the ask is information: either the $1 million figure is a trailing number the seller knows won't repeat, it's a gross or lightly adjusted figure rather than earnings, there's open audit or recoupment exposure, or the seller needs out on a timeline that has nothing to do with value. The multi-service mix (ABA plus speech, OT, and counseling) means multiple billing code families and payer relationships to verify, which raises the diligence load and the chance that one of those lines is a problem.
Approach it like a workout, not an acquisition: verify collections rather than billings, pull the payer remittances by service line, quantify any open audit exposure, confirm the BCBA roster is actually employed and staying, and map payer credentialing transfer under a change of ownership before assuming revenue continuity. If even half the stated cash flow survives that process, the price is a gift. The number itself suggests the seller doesn't expect it to, and your diligence budget should assume they're right until proven otherwise.
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Thanks for the read, and let me know what you think!
- Will
The Weekly Checkup is published every Tuesday morning. Written for general informational purposes. Access to Scope Research healthcare M&A databases or valuation consulting engagements through HealthFMV require a separate agreement.