The Weekly Checkup: Week of June 29-July 3, 2026

49 announced transactions this abbreviated holiday week, up from last week's 42, with Services 22, Technology 27, and 4 platform deals. The technology count outpacing services for a second consecutive week is a little surprising, and is lead by continued strength in pharma services and life sciences deal activity.

QuidelOrtho (Nasdaq: QDEL) announced it’s exploring the sale of its point-of-care testing segment at a prospective valuation of approximately $1.5 billion, with Advent International, SK Capital, and Archimed reportedly among the bidders. The POC segment includes rapid immunoassay testing for influenza, RSV, COVID-19, and other infectious diseases across major brands including Sofia and Solana.

My take: The QuidelOrtho situation is now perhaps the #1 case study where a COVID-era acquisition thesis didn’t pan out. Quidel paid approximately $6 billion for Ortho Clinical Diagnostics in 2022, leaving QuidelOrtho with $3.8 billion in debt against a market cap that has spent much of 2026 below $1 billion. The POC segment represents approximately 22% of company revenue per the 2025 annual report, implying full-year 2025 POC revenue in the range of $550 to $600 million. Q1 2026 POC revenue came in at $113 million, down 34% year-over-year on respiratory season weakness, which on an annualized basis suggests a normalized revenue run rate closer to $450 to $500 million. At $1.5 billion against that revenue range, the implied EV/revenue multiple is in the mid- to high- 2x range. In terms of EBITDA multiples, some reports have suggested that the ask represents a 10-12x multiple, implying that the segment’s margins are slightly higher than the company's overall 22% adjusted EBITDA margin. The risk to a potential buyer is that influenza seasons have been structurally volatile post-COVID and that the market still has yet to find a reliable baseline.

Deal value: $21.5 million | EV / Revenue: 2.2x | EV / EBITDA: 6.9x

Strata Critical Medical (Nasdaq: SRTA) acquired Heart and Lung Transplant National Recovery Program, a Florida-based contracted surgical recovery network, for $21.5 million (approximately 80% cash, 20% stock with a multi-year lockup tied to the seller's continued participation). HLT-NRP is expected to generate $10 million in revenue and $3.1 million in adjusted EBITDA for full-year 2026.

My take: HLT-NRP is not what the name suggests. It’s not a transplant center, a hospital department, or a physician practice in the conventional sense. It is a contracted surgical recovery services network: a team of independent cardiothoracic surgeons and clinical coordinators, led by Dr. Samuel Jacob (former Mayo Clinic Florida), who travel to donor hospitals on behalf of transplant centers and OPOs to evaluate, surgically recover, and transport donor hearts and lungs. The business model is fee-for-service, billed to the transplant center receiving the organ rather than to a payer, which means no claims processing and no reimbursement rate risk — the revenue is purely a function of recovery volume and contract pricing. The 31% EBITDA margin on $10 million of revenue reflects that structure. This is not a traditional physician practice and it is not a traditional staffing company. It sits in a clinical niche where the supply of surgeons willing and trained to do this work is very small (traveling to a donor hospital at any hour to perform a time-critical cardiothoracic surgery is not a role that scales easily) and that scarcity is what the multiple is buying.

The 20% stock component with a multi-year lockup tied to Dr. Jacob's continued participation is the most important structural detail in the deal. Strata is not buying a book of contracts or a piece of equipment. It is buying the professional relationships and clinical credibility that Dr. Jacob and his team have built with transplant centers and OPOs over years of reliable recovery work. If that team disengages, most of the value goes with them. The lockup is Strata's mechanism for managing that risk. Whether it is adequate depends on whether $21.5 million in total consideration, with only 20% in equity, is sufficient to retain a physician-founded organization whose principals could re-form independently after any lockup expires.

The CPOM question is also worth raising. Florida restricts corporate ownership of physician services, and Strata acquiring a physician surgical team directly creates structural complexity. The deal is likely structured through a management services agreement with a physician-owned professional entity rather than a direct employment arrangement, but that structure is not disclosed. Any buyer or analyst assessing Strata's Transplant Clinical platform should understand how the physician employment and service agreements are structured, because the regulatory architecture of the physician relationship determines both the durability of the revenue and the regulatory exposure of the platform.

Banner Health signed an asset purchase agreement to sell Banner Lassen Medical Center, a community hospital in Susanville, California, to an affiliate of Quorum Health. The transaction is expected to close in December 2026 pending regulatory approvals.

My take: We covered Quorum Health's conversion from for-profit to nonprofit status a few weeks ago, and our analysis centered on the assumption that this was a clearly distressed operator finding its last viable exit route. This transaction creates an interesting bookend: the newly converted nonprofit Quorum is now acquiring a community hospital, pulling a full 180 from the divestitures and closures that defined its history as a taxable enterprise. A few things make Banner Lassen a logical Quorum acquisition. Lassen County is a rural California market where Quorum has experience operating small and mid-sized community hospitals, and Banner Health's stated rationale suggests this is about finding an operator who can sustain services that Banner finds operationally challenging to justify on a small scale. The nonprofit structure Quorum now operates under changes its access to state and federal rural hospital support programs, which may change their directive going forward. Maybe this is the beginning of a new growth strategy rather than an isolated opportunistic transaction.

Cathay Capital launched Ascendia Autism Care as a new ABA therapy platform anchored by a founding affiliate operating 20 centers across eight states. The platform will focus on expanding access to evidence-based Applied Behavior Analysis therapy for children with autism.

My take: ABA therapy platform formation has been one of the more active subcategories in behavioral health PE for the last several years, and Cathay Capital is entering a category that has seen significant consolidation: BCBA shortages, payer contracting complexity, and the operational demands of running high-quality ABA programs with consistent clinical supervision have created a wide performance gap between well-resourced platforms and independent practices. The 20-center, 8-state founding footprint is a meaningful starting point. North Arrow ABA's conversion to an ESOP this week, where founders chose employee ownership over a PE sale, is an interesting counterpoint: in ABA as in other behavioral health categories, the exit decision for founders is increasingly not just about price but about what ownership model best preserves the clinical culture they have built.

I tracked 45 additional transactions this week, including Ipsen's acquisition of Kartos Therapeutics for up to $1.7 billion (oral MDM2 inhibitor for myelofibrosis); Zimmer Biomet's acquisition of the iovera° cryoneurolysis business from Pacira BioSciences for up to $140 million; Theravance Biopharma's agreement to be acquired by Zymeworks for $17.00 per share plus a CVR; Peak Rock Capital's acquisition of Asembia (specialty pharmacy commercialization technology); Experity's acquisition of Exdion Healthcare (AI-driven RCM for urgent care); Sharp HealthCare's 30-year lease of Tri-City Medical Center in Oceanside; and Guardian Pharmacy Services' acquisition of Wellness Concepts (LTC pharmacy, Shenandoah Valley). The complete list is available to subscribers.

Deal value: $16.55 million | EV / Revenue: 0.5x | EV / EBITDA: 6.5x

This weeks from the vault is a deal we originally overlooked and missed the financial details on: Newly launched publicly-traded Canadian roll-up Custom Health Holdings' acquisition of InnovativeRx US Holdings, an Indiana-based specialty pharmacy and medication management platform, for $16.55 million. The press release disclosed LTM revenue of $34.3 million and adjusted EBITDA of $2.53 million, a 7.4% margin. The transaction was structured as an acquisition of InnovativeRx's operating subsidiaries rather than the full corporate entity, which is a common structure for pharmacy acquisitions where specific licenses and accreditations need to transfer cleanly. Custom Health described InnovativeRx as a platform for integrated medication management with relationships across long-term care, assisted living, and home infusion settings in Indiana.

What the financials tell us: The 7.4% EBITDA margin on $34.3 million of specialty pharmacy revenue is notably thin. Well-run specialty pharmacy businesses typically produce EBITDA margins in the 10% to 20% range depending on therapeutic category and payer mix, with the higher end reserved for oncology, rare disease, and other high-acuity therapeutic areas. A 7.4% margin suggests either a drug mix weighted toward lower-margin specialty categories, a cost structure with significant overhead relative to the dispensing volume, or both. At $16.55 million for $34.3 million in revenue, the 0.5x revenue multiple is at the low end of where specialty pharmacy transactions have cleared, which is consistent with the margin profile: buyers pay more for specialty pharmacy businesses that generate real EBITDA.

Why it matters: The InnovativeRx transaction is a useful anchor for this week's pharmacy listings. The 6.54x EBITDA multiple on a thin-margin specialty pharmacy platform tells you where the floor is for businesses in this category that are not yet optimized: a buyer is paying for the licenses, the accreditations, the payer contracts, and the patient relationships, with the expectation that margin improvement follows operational integration. That expectation is the thesis. Whether it materializes depends on the acquirer's ability to overlay shared services, improve purchasing leverage, and grow volume in the therapeutic areas where the margins are better.

Scope Research's valuation database has approximately 2,900+ healthcare M&A transactions with disclosed or derived revenue and EBITDA multiples going back to 2010.

This week's listings are all pharmacy, spanning five distinct models: a high-volume 340B specialty pharmacy with a wholesale license, a national closed-door specialty pharmacy, a multi-location retail chain, a large home infusion platform, and a thin-margin LTC pharmacy. Together they illustrate the full valuation range of the category and the extent to which pharmacy multiples are driven by license type and drug mix rather than revenue scale.

Location: New York County, NY | Asking Price: $12.0M | Revenue: $25.8M | Cash Flow: $2.2M | CF Margin: 8.5% | Price / Revenue: 0.47x | Price / Cash Flow: 5.45x

20-year-old specialty pharmacy dispensing 700 prescriptions per day from a 10,000 sq. ft. Manhattan facility. Holds an active 340B contract, a wholesale license, and a new HIV collaborative agreement allowing direct HIV testing and prescribing. Both owners are departing.

My take: The 340B contract and the HIV collaborative agreement are the two assets doing most of the valuation work here, and both require careful diligence. A 340B contract with a covered entity gives the pharmacy access to drug pricing that creates margin that would not otherwise exist at retail or specialty rates. The HIV collaborative agreement allowing direct testing and prescribing is a newer arrangement under New York's collaborative drug therapy management statute, and the revenue potential from the HIV specialty segment is meaningful: HIV medications are among the highest-margin specialty categories in pharmacy, and a pharmacy with a collaborative agreement has a defensible competitive position for that patient population. The wholesale license is a separate revenue channel that adds B2B income on top of the dispensing book. The 8.5% cash flow margin is below what this combination of assets should produce at steady state, which means either the overhead is elevated relative to the dispensing volume or the 340B and HIV economics have not yet been fully captured in the disclosed financials. The "two-package deal" framing in the listing suggests a consolidation of two related entities, which adds legal and operational complexity that a buyer needs to map before engaging on price.

Location: Monmouth County, NJ | Asking Price: $20.0M | Revenue: $12.0M | Cash Flow: $2.0M | CF Margin: 16.7% | Price / Revenue: 1.67x | Price / Cash Flow: 10.0x

Nationally accredited closed-door multi-specialty pharmacy operating across 40 states with government program participation, GPO contracts, and major payer network relationships.

My take: The 10.0x cash flow ask is high for a $12 million revenue pharmacy and requires the license infrastructure to justify it. Closed-door specialty pharmacies with 40-state licensure, URAC or ACHC accreditation, and established GPO and payer contracts command premiums over single-state retail pharmacies because the licensing stack represents years of regulatory work and ongoing compliance overhead that a buyer cannot replicate quickly. The 16.7% cash flow margin is reasonable for a specialty pharmacy with this profile and suggests a drug mix weighted toward higher-margin categories. The most important diligence questions are the therapeutic category concentration, whether the 40-state licenses include the states where the most valuable payer contracts apply, and whether the GPO contracts are assignable on a change of ownership. A buyer who needs the multi-state closed-door infrastructure for their own expansion and cannot achieve it through internal build in the near term will find the licensing premium justified. A buyer who already has similar infrastructure will find the 10.0x ask harder to underwrite.

Location: Suffolk County, NY | Asking Price: $3.0M | Revenue: $11.5M | Cash Flow: $422K | CF Margin: 3.7% | Price / Revenue: 0.26x | Price / Cash Flow: 7.09x

Five-location neighborhood pharmacy chain with more than 50 years of operating history in Suffolk County. Compounding services and multiple revenue streams. Experienced staff.

My take: The 3.7% cash flow margin is the central challenge here. Five-location retail pharmacy with $11.5 million in revenue and $422,000 in cash flow is a business operating at the margin of viability, and the 7.09x cash flow ask requires a buyer who believes the margin is structurally improvable rather than reflective of competitive conditions in the Suffolk County retail pharmacy market. The 50-year operating history is a meaningful asset in terms of patient loyalty and prescription transfer risk, but it also means this is a mature book in a market that has been under sustained competitive pressure from chains, mail-order, and PBM formulary management for decades. The 0.26x revenue multiple is cheap in absolute terms: at $3 million for $11.5 million in revenue with compounding services and a 50-year local brand, a buyer who can add a 340B contract, improve purchasing leverage through a GPO, or introduce delivery and adherence programs that improve cash flow has a potential upside that the asking price does not require them to pay for. The compounding capability is a differentiator if the regulatory posture (USP compliance, state board accreditation) is current.

Location: Texas | Asking Price: $48.5M | Revenue: $60.0M | EBITDA: $7.0M | EBITDA Margin: 11.7% | Price / Revenue: 0.81x | Price / EBITDA: 6.93x

Texas specialty pharmacy with estimated 2025 gross revenue of $60 million and adjusted EBITDA of $7.2 million. The seller seeks strategic partners with extensive healthcare industry experience and established managed care relationships.

My take: We covered this listing in Issue #8 and it is still active. The core analysis holds: the 0.81x revenue and 6.93x EBITDA ask is reasonable for a Texas specialty pharmacy platform, but the "strategic partners with healthcare industry experience" language in the listing description signals that this is not a retail buyer opportunity. The therapeutic category concentration and payer network status remain the key unknowns, and the continued availability of the listing at the same price after several weeks suggests the buyer who fits the profile has not yet appeared or has not cleared diligence. For a specialty pharmacy platform or a health system looking to bring specialty dispensing in-house in Texas, the fundamentals of the asset may be worth exploring.

Location: Pennsylvania / Maryland | Asking Price: $3.0M | Revenue: $16.0M | Cash Flow: $250K | CF Margin: 1.6% | Price / Revenue: 0.19x | Price / Cash Flow: 12.0x

40-year-old long-term care pharmacy with four locations serving approximately 3,300 SNF, ALF, and CCRC beds across Pennsylvania and Maryland. Established accounts with multi-year relationships. Full staff expected to remain.

My take: This listing is priced at $3 million for a reason, and the reason is the 1.6% cash flow margin. LTC pharmacy is structurally one of the more margin-compressed categories in pharmacy: Omnicare's bankruptcy and sale to GenieRx Holdings, which we covered in Issue #6, is the macro context for what happens when a large LTC pharmacy cannot generate sufficient cash flow to service its obligations. A four-location, 3,300-bed LTC pharmacy generating $16 million in revenue with $250,000 in cash flow is a business that covers its operating costs and not much more. The 0.19x revenue multiple is among the lowest we see in any pharmacy category and reflects that margin reality. The value for a buyer is not in the current earnings; it is in the licensed bed relationships. LTC pharmacies with long-term SNF and ALF contracts have patient acquisition costs that are essentially zero, and the switching cost for a nursing home that changes pharmacy providers is significant (patient profile transfers, blister pack reformulation, staff retraining). A buyer with purchasing leverage and a more efficient operating model than the current owner can potentially improve the margin from 1.6% to 8% to 10%, at which point the $3 million entry price looks very different. That margin improvement is the entire thesis, and whether it is achievable depends on the buyer as much as it does the cost structure details that the listing does not disclose.

That's it for this week. Forward to one person, reply with feedback, and reach out directly if you are exploring a transaction, valuation, or FMV engagement.

Will Hamilton, CVA

Founder, Scope Research and HealthFMV

The Weekly Checkup is published every Tuesday morning. Written for general informational purposes. Engagements through Scope Research or HealthFMV require a separate agreement.