What To Do When It All Goes Wrong – A Glimpse into MSO Turnarounds

Home Insights Bulletin Board What To Do When It All Goes Wrong – A Glimpse into MSO Turnaround

Over the past two quarters, we have seen greater activity amongst lenders focusing on, and in certain cases assuming ownership of, underperforming assets. 

Here are the top recurring pain points in the MSO market today:


Failure to meet the phase-specific needs of an MSO as it evolves from an independent platform to first institutional ownership to a regional MSO to a multi-regional / national MSO.


Gaps in accrual revenue collection and conversion


Overpaying for add-on acquisitions is due to either (i) prioritizing growth over sustainable performance or (ii) weak diligence or deal structuring resulting in meaningfully higher than anticipated effective multiples.




Poor controls around inventory management and tracking of COGS, especially for expensive, low margin drugs and medical supplies.

Turnaround Execution

Partial and siloed project teams are often insufficient to get the job done. It is the core multidisciplinary project teams with strong representation across the below skill sets that are conditioned for success:

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