By Diwakar Sinha

If you’re a founder or executive leading an MSO or DSO, you’ve lived through one of the most volatile capital cycles in recent memory. You’ve seen cheap money fuel aggressive expansion, you’ve felt the pressure of rising rates, and you’ve watched the market shift from frenzy to caution almost overnight.

But something important has changed.

2026 is the first year in a long time where the wind is finally at your back again.

Not because the world suddenly became easier, but because the capital markets, buyer appetite, and valuation environment are finally aligning in a way that favors strong, founder‑led platforms.

And if you’ve built something meaningful, this is the moment to pay attention.

SOFR Has Quietly Reopened the Market

For years, SOFR dictated the pace of M&A:

  • Near‑zero rates made capital almost free
  • A spike above 5% crushed cashflow and stalled deals
  • Now, SOFR has meaningfully eased

Lower borrowing costs don’t just help lenders they directly improve valuations, deal structures, and buyer participation. The economics of recapitalization look better today than at any point since the pre‑COVID boom.

This shift alone is enough to spark renewed activity. But it’s only part of the story.

Valuations in Healthcare Services Are Strengthening

After two years of compressed multiples, the market is recalibrating. Buyers are returning with discipline, but also with conviction. They’re looking for:

  • Scaled platforms
  • Strong unit economics
  • Clear growth stories
  • Founder‑led cultures

Healthcare services especially dental, pediatric, and multi‑site care models are seeing meaningful increases in buyer interest. The groups that come to market early in this cycle are capturing the strongest outcomes.

Family Offices and Long‑Term Investors Are Leaning In

One of the biggest shifts in the last 18 months is the rise of long‑duration capital in healthcare.

Family offices and long‑term investment groups are increasingly drawn to MSOs and DSOs because they offer:

  • Recurring revenue
  • Predictable cashflow
  • Strong demographic tailwinds
  • Opportunities for multi‑site expansion

These investors aren’t looking for quick flips. They care about:

  • Culture
  • Mission
  • Legacy
  • Long‑term value creation

For founders who want a partner not a buyer this is a fundamentally different conversation.

Strategics Are Repositioning and Looking for Anchors

Strategic buyers spent the last two years stabilizing operations and managing debt. Now they’re back, and they’re not looking for small add‑ons.

They’re looking for:

  • Regional anchors
  • Category leaders
  • Scaled platforms with strong management teams

If your organization sits in a region where strategics have a gap, or if you operate in a specialty they want to expand into, you are exactly the type of asset they’re trying to find.

Founder‑Led Platforms Are in the Highest Demand

Across the buyer universe, one theme is consistent:

Founder‑led healthcare platforms are the most desirable assets in the market.

Why?

Because founders build:

  • Strong cultures
  • Loyal teams
  • Consistent patient experiences
  • Disciplined operations
  • Authentic brands

These qualities are extremely difficult to replicate and buyers know it.

In a market where capital is returning but discipline remains high, founder‑led platforms command a premium.

Why 2026 Is the Year to Evaluate Your Options

When you combine all of these forces, the picture becomes unmistakable:

  • SOFR has eased
  • Valuations are strengthening
  • Buyers are active again
  • Family offices are leaning in
  • Strategics are repositioning
  • Founder‑led platforms are in demand

This is not a normal year. It’s a window.

And windows don’t stay open forever.

For larger MSOs and DSOs, the process takes time aligning financials, preparing data, shaping the growth story, and running a thoughtful, competitive process.

Starting early in 2026 gives founders the best chance to:

  • Maximize valuation
  • Choose the right partner
  • Control timing
  • Protect culture
  • Capture the upside of a strengthening market

Even if you don’t transact this year, understanding your options now ensures you’re not reacting to the market you’re leading it.

The Bottom Line

The last cycle rewarded speed. The next cycle will reward preparation.

If you’ve built a scaled, profitable, founder‑led MSO or DSO, 2026 is the year to evaluate a recapitalization or sale from a position of strength.

Not because you have to. Because the market is finally giving you the opportunity you deserve.

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