The 2026 PE Rebound: Is Your Specialty "Back in Fashion"?

"If a Private Equity firm offered you a $10M check today, would you sign it immediately, or would you wonder why they’re suddenly so desperate to get back into the room with you?" 

For the past 24 months, the healthcare private equity (PE) market felt like a silent waiting room. High interest rates and a "valuation gap" between what doctors wanted and what funds would pay created a stalemate. But as we move into early 2026, the silence has been replaced by a surge of activity. PE firms are currently sitting on a record $2.5 trillion in "dry powder", and the pressure to deploy that capital has reached a boiling point. 

The question for you isn’t just about "selling out", it’s about understanding why the 2026 "rebound" looks nothing like the roll-ups of five years ago. 

The Shift to "Infrastructure Equity" 

The 2026 buyer is no longer interested in just "buying your patients." They are buying your Infrastructure. 

The Trend: In 2026, PE firms are prioritizing practices that have moved beyond human-heavy administration. If your practice uses Agentic AI to autonomously handle prior authorizations and RCM, your valuation multiple could be 2x higher than a traditional practice. 

The Multiplier: We are seeing a "flight to quality." Scaled platforms in Cardiology and Orthopedics—specialties that are successfully migrating high-acuity cases to ASCs—are commanding multiples between 10x and 13x EBITDA. 

Is Your Specialty on the "2026 Heat Map"? 

Not all specialties are rebounding at the same rate. This year, the capital is flowing toward high-acuity, outpatient-centric models: 

Cardiology & Vascular: With the 2026 CMS rule moving complex catheterizations to the ASC, cardiology is the #1 "contested" sector for PE capital this year. 

Orthopedics & Spine: The "Outpatient Super-Cycle" has made musculoskeletal (MSK) platforms the premier defensive play for 2026. 

Infusion & Oncology: Predictable, biologic-heavy revenue streams are being snatched up by funds looking for "recession-proof" cash flow. 

The "Second Bite" and New Legal Shields 

For the mid-career surgeon, the most important term in a 2026 deal isn't the "purchase price"—it's the "Equity Roll." 

The Move: Many 2026 deals are structured as Minority Recapitalizations. By rolling 40% of your equity into a larger, tech-enabled platform, you are betting on a massive "second bite" when the platform is sold to a global strategic buyer in 3–5 years. 

The Shield: Be aware of the "Great Unwinding." New state laws (like California’s SB 351) now strictly codify the Corporate Practice of Medicine, ensuring that PE owners cannot interfere in your clinical staffing or billing decisions. 

In 2026, the market isn't just buying your labor; it’s buying your Clinical Moat. If you have built a practice that uses technology to protect its margins, you aren't just "in fashion"—you are the most valuable asset in the room. 

  Disclosure

This content is for informational purposes only and does not constitute investment, tax, or legal advice. Investment opportunities involve risk, including the possible loss of principal. Investors should consult their own financial, tax, and legal advisors before making allocation decisions. Nothing herein constitutes an offer to sell or a solicitation to buy any security. Self-directed retirement strategies may not be appropriate for all investors.