Polaris: The Growth Architect Helping Healthcare Leaders Scale with the $3M–$75M Middle Market Lending Playbook

By Diwakar Sinha, CEO, Polaris Healthcare Partners 

From $3M to $75M in capital — and the strategic partnership to turn it into exponential growth.

The Scaling Challenge for Emerging Healthcare Groups

In today’s healthcare market, the competition isn’t just the practice down the street — it’s the well‑funded regional and national platforms with deep pockets, aggressive expansion plans, and the infrastructure to execute them.

If you’re an emerging physician group, aesthetic practice, or dental organization in the lower middle market, you already know: to compete at that level, you need more than a loan. You need a capital strategy — and a partner who can help you execute it.

That’s where Polaris comes in.

Beyond the Transaction: Capital as a Growth Engine

Most advisors think their job ends when the capital hits your account. Ours starts there.

We don’t just secure you a $3M–$75M secured credit facility — we help you deploy it strategically to scale in two powerful ways:

• Acquisitions — Buying established practices to quickly expand market share, add service lines, and consolidate your position.
• De Novos — Launching brand‑new locations in high‑opportunity markets, built from the ground up to your exact specifications and brand standards.

The right mix of acquisitions and De Novos can transform your growth curve from steady to exponential — and we know how to structure your facility so you can do both without missing a beat.

The Lending Reality: How Banks Size Credit

In the lower middle market (LMM) and middle market, lenders typically size credit using two primary methods:

1. Leverage on EBITDA

• Typical Range: 2.5x – 3.5x leverage on adjusted EBITDA for LMM healthcare deals.
• Example: If your adjusted EBITDA is $4M, lenders may size total debt between $10M and $14M.

2. Advance Rate on Revenue

• Typical Range: 50% – 70% of trailing twelve‑month revenue, depending on subsector and collateral profile.
• Example: A $20M revenue group could see a facility sized between $10M and $14M.

Other Factors That Influence Lending Capacity

Beyond the math, lenders weigh:

• Growth Strategy: Acquisition vs. De Novo mix, and how each impacts cash flow ramp‑up.
• Management Depth: Bench strength to execute and integrate growth.
• Collateral Quality: Liquid, verifiable assets that can support the facility.
• Regulatory & Compliance: Clean billing practices, HIPAA adherence, and audit readiness.
• Integration Track Record: For acquisitive groups, proof you can integrate without operational disruption.

The Polaris Advantage: Structuring for Scale

Where most borrowers go wrong is treating each acquisition or De Novo as a separate financing event. That slows momentum and creates uncertainty.

At Polaris, we:

1. Build a Master Facility — Sized to your growth plan, not just your current deal.
2. Blend Acquisition & De Novo Capacity — So you can execute both without re‑approvals.
3. Position for Approval — We translate your growth vision into the language of credit risk, cash flow stability, and asset coverage.
4. Stay Engaged — We remain on retainer to manage lender relationships, monitor performance, and keep your facility expandable.

Staying in the Game: Our Retainer Partnership

Growth is only half the battle. The other half is maintaining a strong, ongoing relationship with your capital partners, so your facility remains a reliable, expandable source of funding.

That’s why many of our clients keep Polaris on retainer after the deal closes. We:

• Monitor performance and proactively address potential issues.
• Maintain open, positive communication with lenders.
• Advise on capital allocation to ensure every dollar is working toward your long‑term goals.

This ongoing relationship means you’re never flying blind — and your lender is never surprised.

Why This Matters: Competing With the Big Players

Larger platforms have teams dedicated to capital strategy, lender relations, and growth execution. With Polaris, you have the same firepower — without having to build it in‑house.

We give you:

• The insider’s view of how lenders think, so you’re always positioned for “yes.”
• The strategic roadmap to balance acquisitions and De Novos for maximum impact.
• The operational discipline to keep your facility healthy and expandable.

The result? You’re not just keeping up with the big players — you’re outmaneuvering them.

The Polaris Difference

We’ve been the lender. We’ve approved and declined deals. We know what makes a credit committee lean in — and what makes them walk away. That knowledge shapes every step we take with you, from structuring your facility to managing it over time.

When you work with Polaris, you’re not just getting capital. You’re getting a growth partner who knows how to turn that capital into market dominance.

If you’re ready to scale, through acquisitions, De Novos, or both — let’s talk. We’ll bring the playbook, the lender relationships, and the ongoing partnership to take you from where you are to where the big players are… and beyond. Our mission is to turn complexity into opportunity and ambition into legacy. Contact us to explore more.