The practices that command 9.0x EBITDA at exit were not sold — they were built for it. A decade of intentional capital deployment, clinical differentiation, operational architecture, and exit preparation separates the practitioner who exits at 5.5x from the one who exits at 9.0x on the same revenue base.
Initialize Practice Equity AssessmentMost optometrists think about their exit in the final 2–3 years of practice ownership, when the decisions that determine the exit multiple were made — or missed — years earlier. Lumina Medical Capital presents the 10-year framework that transforms exit planning from a reactive event into a proactive capital strategy executed from the first day of ownership.
Same $420K EBITDA. $2.1M vs. $3.99M exit proceeds. The difference is the blueprint.
The first two years establish the physical and operational foundation. Deploy diagnostic technology that enables medical-grade coding: OCT, visual field analyzer, corneal topographer. Execute leasehold improvements that signal clinical quality. Establish entity structure with legal counsel — PC + operating entity — that is clean, documented, and acquisition-ready. Open the practice's first retirement account and begin maximizing contributions. Set up accounting systems that produce EBITDA-readable financials from year one. The exit buyer underwrites 3 years of financials — everything from year one forward is underwriting evidence.
Add the service lines that retail chains cannot replicate: dry eye treatment center, specialty contact lens fitting program, myopia management for pediatric patients, medical eyecare billing for diabetic retinal exams and glaucoma management. Each new revenue stream adds EBITDA at different margins and creates a more diversified revenue base — which lenders and buyers price at a higher multiple than single-stream practices. By year 4, no single revenue category should exceed 50% of total collections.
Hire the first associate OD. Structure compensation with a 3–5 year partnership track clearly documented. The associate's production reduces the owner's personal revenue share — from 100% to 60% — which is the single most powerful multiple-multiplying action available to an independent practice owner. By year 6, the practice should generate 35–40% of revenue through the associate, and the owner should have initiated the lease extension that covers a prospective buyer's first 3–5 years of operation.
Years seven and eight are for EBITDA margin optimization — the discipline that separates the 7.5x practice from the 9.0x practice. Audit every operating expense against industry benchmarks. Renegotiate vendor contracts (frame lines, contact lens distributors, software subscriptions) that have not been repriced in 3+ years. Optimize staff structure and compensation levels against revenue-per-employee metrics. Engage the healthcare CPA to review compensation add-backs that can be normalized out of EBITDA. Establish the trailing-12-month revenue and EBITDA figures that a buyer will use to underwrite the transaction.
One year before a planned exit, activate the full advisory team: capital advisor, healthcare CPA, medical practice attorney. Commission a formal practice valuation to establish current market value and identify any remaining value gaps. Resolve all compliance deficiencies — HIPAA, OSHA, ADA — before the transaction begins. Document patient recall rates, staff tenure, payer mix percentages, and revenue-per-exam figures. Prepare a Confidential Information Memorandum (CIM) with Lumina that presents the practice's story in institutional language. The goal of year nine is to have nothing a due diligence process can surprise you with.
Year ten is for execution, not preparation. With the advisory team assembled, the CIM prepared, and the practice in its highest operational state, the market process begins. Multiple qualified buyers are approached simultaneously — creating competitive tension that drives the offer toward the top of the market range. The Letter of Intent is negotiated from a position of strength, the due diligence period runs on a documented, organized practice with zero surprises, and the closing occurs at the multiple the preceding decade of effort has earned.
Each phase of the blueprint adds both EBITDA and multiple — compounding to create an exit value that is exponentially greater than the sum of its parts.
| Blueprint Phase | Est. EBITDA | Multiple Range | Exit Value Range |
|---|---|---|---|
| Y1–2: Foundation (Pre-blueprint) | $180K | 4.5–5.0x | $810K–$900K |
| Y4: Revenue Diversified | $280K | 5.5–6.5x | $1.54M–$1.82M |
| Y6: Associate Integrated | $360K | 6.5–7.5x | $2.34M–$2.70M |
| Y8: EBITDA Optimized | $420K | 7.5–8.5x | $3.15M–$3.57M |
| Y10: Full Blueprint Executed | $420K | 8.5–9.5x | $3.57M–$3.99M |
Illustrative model. Individual results depend on market conditions, clinical specialty mix, geographic location, and execution quality. Not a projection or guarantee of value.
Every Arizona optometry practice is somewhere in this 10-year arc — whether the owner is intentional about it or not. The question is not whether you will exit. The question is whether the exit you execute reflects the decade of work you invested in the practice, or the decisions you deferred.
Lumina's Practice Equity Assessment identifies your current position in the blueprint, quantifies the multiple gap between your practice today and its maximum potential, and maps the specific capital investments and operational changes that close that gap — in the time you have available.
Initialize Practice Equity AssessmentThe blueprint leads to an exit. Before executing, understand all seven exit structures — their multiples, timelines, tax outcomes, and post-close considerations — to ensure you choose the path that maximizes what you actually receive.
Explore Exit Strategies →Ten years of intentional practice building. One assessment to understand where you stand — and what your practice is worth, today and at maximum potential. Lumina's Practice Equity Assessment is the starting point for every client relationship we build.
Initialize Practice Equity Assessment