Spain's private healthcare sector is consolidating at pace, with international buyers actively acquiring clinic groups. If you own a dental group, medical centre chain, or healthcare company with €3M+ in revenue, this guide explains valuation, buyer dynamics, and how to protect your team and patients.
If you own a clinic group — dental, medical, physiotherapy, aesthetic, or veterinary — with combined revenues above €3 million annually, you are operating in one of Spain’s most actively consolidating sectors right now.
The consolidation of Spain’s private healthcare sector is not a future trend: it is happening at accelerating pace, with both domestic and international buyers active in the market. Understanding how this process works, what buyers value, and how to protect what you have built is the essential starting point for an informed decision.
Spain’s private healthcare market exceeds €12 billion annually and is growing at 5-6% per year, driven by an ageing population, public system waiting lists, and increasing penetration of private health insurance.
This growth has attracted institutional capital seeking to build multi-location platforms capable of competing with large insurers and hospital groups. The model is well-established: acquire independent centres or regional groups, integrate them under common management and brand, and capture economies of scale in procurement, technology, and administration.
The dental sector has led this wave. Groups including Vitaldent, Sanitas Dental, Asisa Dental and dozens of regional operators have transformed a sector of family clinics into a consolidated market with national and international scale players. The same process is occurring — with some lag — in aesthetic medicine, physiotherapy, veterinary care, and diagnostic centres.
For the owner of a clinic group who has built their business over ten or twenty years, this consolidation represents both an opportunity and a risk. An opportunity because institutional buyers are paying multiples that would have seemed extraordinary a decade ago. A risk because not all buyers offer the same guarantees for the clinical team, patients, and centre culture.
Before proceeding, it is worth clarifying who this guide is written for.
It is not written for the solo dentist with a single clinic and two assistants, nor for the physician seeing private patients in individual practice. Those profiles have a limited transferable value and a different buyer market.
This guide is written for the owner of a clinic group that meets at least these characteristics:
If your group meets these criteria, you have an asset with genuine value to institutional buyers.
Healthcare company valuations are conducted on EBITDA multiples, but the ranges vary significantly by subsector:
Dental groups: 7x-10x EBITDA. Dental is the subsector with the highest multiples, driven by income predictability (long-duration treatments, recurring payments), business model maturity, and strong buyer appetite. Groups with 8-10 or more clinics and professionalised central management reach the upper end.
Private medical centres and polyclinics: 5x-8x EBITDA. The range is wider because business heterogeneity is greater. A diagnostic centre with proprietary imaging equipment (CT, MRI) may value higher than a consultation-only polyclinic. Specialisation in specific fields (oncology, cardiology, orthopaedic surgery) adds value.
Physiotherapy and rehabilitation chains: 5x-7x EBITDA. Physiotherapy chains have predictable business models and solid margins, but face greater price pressure from public system competition and collective agreements.
Aesthetic medicine clinics: 6x-9x EBITDA. The medical aesthetics sector has gained attractiveness through sustained demand growth and high margins. Buyers are, however, more rigorous in regulatory due diligence and clinical team retention assessment.
Veterinary groups: 6x-8x EBITDA. Veterinary chains are among the most M&A-active sectors across Europe. Groups including IVC Evidensia, Anicura and Pets At Home have completed hundreds of Spanish acquisitions. The buyer profile is predominantly international.
Beyond gross EBITDA, institutional buyers assess qualitative factors that can account for 20-40% differences in final valuation.
Clinical team retention. The most valuable asset in any clinic is not the chairs or equipment: it is the practitioners. A buyer who acquires a dental group and loses its key dentists in the months after closing has bought something worth far less than they paid. Serious buyers evaluate team stability rigorously, including the existence of retention agreements and the culture of the group.
Patient loyalty. The active patient portfolio — those who have visited the centre in the last twelve months — and their treatment history constitute one of the most important assets. Buyers analyse year-on-year retention rates, average revenue per patient, and average patient tenure.
Revenue diversification. A dental group that depends 80% on orthodontics carries concentration risk. A group that balances implantology, orthodontics, endodontics, and aesthetic dentistry has a more resilient revenue base. Service diversification is a positive valuation factor.
Management model. Buyers pay more for groups that have a medical or operations director managing clinical activity independently of the owner. A group where the owner is also the primary service provider carries personal dependency risk that depresses the price.
Regulatory compliance. The healthcare sector is heavily regulated: operating licences, staff qualifications, medical waste management, patient data protection (GDPR applied to health data). A regulatory due diligence that uncovers non-compliance can significantly reduce the price or, in serious cases, block the transaction.
In our experience, the most common concern for clinic group owners is not the price. It is what will happen to their team and patients once they sell.
This is a legitimate concern. Some buyers integrate aggressively: they unify protocols, standardise pricing, replace management, and treat practitioners as interchangeable resources. For some clinics, that integration works. For others — particularly those where the centre’s culture and personal patient relationships are the real differentiator — aggressive integration destroys value.
At Blue Mountain, our model is different. When we acquire a clinic group, we do so with the intention of building a long-term platform, not optimising it for resale in four years. This means:
We are not the right buyer for every clinic group. But for the owner who cares about what they leave behind as well as the cheque, we are a genuine alternative to the large groups that acquire to standardise.
If you are considering initiating a sale process, you should anticipate what any serious buyer will analyse in detail.
Operating licences. Are all healthcare operating authorisations current? Is there any pending renewal? Is diagnostic equipment certified and calibrated to date?
Staff qualifications. Do all healthcare professionals hold recognised and registered qualifications? Do clinical assistants hold the correct authorisations?
Clinical team contracts. Are practitioners employed or self-employed collaborators? Are non-compete agreements in place? Do contracts have change-of-control clauses that could be triggered by a sale?
Patient data management. Clinical records are specially protected data under GDPR. Is there an updated Register of Processing Activities? Has a Data Protection Impact Assessment been conducted?
Professional liability insurance. Is coverage adequate for the volume and type of clinical activity?
Clinical contingencies. Are there outstanding patient complaints? Have there been significant clinical incidents in the last five years?
Selling a clinic group typically takes six to twelve months from first contact to closing. The stages are:
Preparation (1-3 months): Data room organisation, EBITDA normalisation, pre-emptive regulatory review, transaction structure definition.
Confidential marketing (1-2 months): Contact with selected potential buyers, confidentiality agreements, information memorandum distribution.
Due diligence (2-4 months): The selected buyer conducts financial, legal, medical-regulatory, and human resources analysis. This is the longest and most intensive stage.
Negotiation and closing (1-2 months): Share purchase agreement negotiation, contingency resolution, conditions precedent, transaction closing.
The particular feature of the healthcare sector is that regulatory and clinical due diligence adds time and complexity to the process. Working with an adviser with specific transaction experience in healthcare is especially important.
We invest in Spanish middle-market companies, including healthcare platforms. Our investment thesis in the sector is straightforward: we look for clinic groups with strong clinical teams, loyal patient communities, and the potential to expand — through additional locations, new specialities, or geographic coverage.
We are patient capital. We do not have a fund closing date that forces us to exit within five years. We do not impose aggressive standardisation that undermines what makes a clinic group distinctive. And we do not replace management teams that built the business.
If you own a clinic group and are considering your options — full sale, partial partnership, or generational succession — we would welcome an initial conversation. Without commitment, in complete confidence, and with the sole objective of ensuring you understand the alternatives available to you.
Contact us or learn about our growth investment approach.
Dirk Manuel Martens Jiménez Founder, Blue Mountain Capital
By Blue Mountain Capital
By Blue Mountain Capital
By Blue Mountain Capital
If you wish to explore a potential collaboration or present an investment opportunity, we invite you to contact us. We guarantee absolute confidentiality in all our conversations.