How to Value a Concierge Medicine Practice in 2026

Concierge medicine is one of the most misunderstood corners of primary care valuation. Sellers routinely assume concierge practices trade like traditional medical practices — 3-4x EBITDA, a local physician buyer, an SBA loan. They don't. A mature concierge practice with a stable retainer book and an affiliated brand trades more like a specialty recurring-revenue business, and the multiples look completely different from anything you've seen in primary care.

Here's how concierge medicine actually gets valued in 2026, why the retainer-only practices trade at a premium to hybrid ones, and what MDVIP, Castle Connolly, and SignatureMD affiliation actually does to your exit number.

Concierge vs. DPC: Not the Same Thing

Before going further, let's separate concierge from Direct Primary Care. Both charge patients a recurring fee, but they're different businesses with different buyers.

DPC eliminates insurance entirely. Patients pay $75-$150/month and the practice doesn't bill payers at all. It's cash-only primary care with SaaS-like economics.

Concierge keeps insurance billing in place and layers an annual retainer on top — $1,500 to $25,000 per patient per year — in exchange for extended visits, 24/7 access, annual executive physicals, and an extremely limited panel (typically 300-600 patients versus 2,000+ in traditional practice). The practice collects both the retainer and the insurance reimbursement, which is why the economics per patient are so strong.

That dual-revenue structure changes the valuation math. Concierge practices trade at 3-6x annual revenue, with the high end reserved for practices that have brand affiliation, high retention, and a premium retainer tier.

The Economics of a Typical Concierge Practice

Consider a physician with 400 concierge patients paying a $2,500 annual retainer. That's $1M in retainer revenue alone, with roughly $250-400K of insurance reimbursement on top (because these patients are still being billed for visits, labs, and preventive care). Total revenue in the $1.25M-$1.4M range, EBITDA margins of 40-55% because the practice has just one physician, two support staff, and much lower visit volume than a traditional office.

At a 4x revenue multiple, that practice is worth $5-5.6M. That's meaningfully more than the same doctor would fetch running a traditional panel of 2,000 insurance patients, even though the concierge practice sees far fewer people. The buyers are paying for the retainer book and the brand — essentially, the privilege of continuing to charge those patients $2,500 a year.

Practices at the top of the retainer scale — $10,000-$25,000/year, often in markets like Manhattan, San Francisco, Miami Beach, and West LA — can trade at 5-6x revenue because the clientele is stickier and the switching cost for the patient is enormous.

MDVIP, Castle Connolly, and SignatureMD Affiliations

The concierge world is dominated by a few platform brands, and whether or not you're affiliated with one matters for valuation.

MDVIP is the largest concierge network in the country, with roughly 1,100 affiliated physicians. MDVIP handles patient acquisition, marketing, the retainer infrastructure, and the brand. In exchange, they take a significant cut of the retainer revenue. An MDVIP-affiliated practice is easier to sell because the brand is transferable and the patient relationship is partially owned by the network. Buyers pay a consistent 3.5-4.5x revenue multiple for MDVIP practices — not the highest in the market, but the most liquid.

SignatureMD and Specialdocs are smaller platform competitors with similar models — affiliated brand, transition services, retainer infrastructure. They offer flexibility MDVIP doesn't, and the economics to the physician are slightly better but the brand is less recognized.

Castle Connolly is a physician-recognition directory, not a concierge platform, but "Castle Connolly Top Doctor" credentialing shows up frequently in concierge marketing and does add meaningful brand credibility. It's not a sale mechanism but it's a marketing asset buyers value.

Independent (non-affiliated) concierge practices have the highest ceiling and the highest floor-level risk. A physician who built the brand themselves keeps 100% of the retainer, but the brand is also founder-dependent. These practices can trade at 5-6x revenue when the buyer trusts the retention math — and at 2.5x when they don't.

The Metrics Buyers Actually Care About

• Retainer retention rate: the percentage of members who renew year over year. Above 92% is excellent, 85-92% is acceptable, below 85% is a problem.
• Panel size: 300-600 is the industry standard. Below 300, the business is sub-scale; above 600, quality-of-service concerns show up in renewal rates.
• Average retainer: the ARPM equivalent. $1,800-$3,500 is mainstream concierge; $5,000+ is premium; $10,000+ is ultra-luxury.
• Years of retainer history: buyers want to see at least 3 years of stable retainer economics.
• Waiting list: a real waiting list (not an aspirational one) is a proxy for pricing power.

Who's Buying Concierge Practices

The concierge buyer pool is small and specialized:

MDVIP itself occasionally acquires affiliated practices from retiring physicians to transition to a new doctor. Not a headline market but consistent.

PE-backed concierge platforms — several PE firms have built concierge roll-ups targeting the high-retainer segment. They buy practices in desirable metros and run them under a shared brand. Expect 4-5x revenue from these buyers.

Another concierge physician — most common for practices under $1.5M in revenue. Usually financed with a combination of bank debt and seller notes.

Local health systems— rarely buyers of concierge practices because the cultural fit is poor and the patient base views health systems as adversarial. When they do buy, it's usually to absorb the retainer book into an existing executive health program.

What Destroys Concierge Practice Value

Retention under 85%. The entire valuation thesis depends on retainer renewal. If your renewal rate is dropping, the buyer assumes a declining revenue curve and discounts accordingly.

Founder-dependent brand."I go to Dr. Anderson" is a killer for concierge valuation because the buyer knows the patient relationship doesn't transfer. This is why MDVIP-affiliated practices trade at more consistent multiples — the brand reduces founder risk.

Hybrid panel confusion. Some concierge practices keep a "traditional" panel alongside their concierge members. Buyers hate this structure because it muddies the revenue story and creates operational complexity. Clean concierge practices trade at higher multiples.

Aging patient base. Concierge patients skew older, and mortality is a real revenue headwind. A panel with an average age of 72 will lose members faster than one averaging 58, and buyers factor this in.

How to Maximize Your Concierge Practice Value

Document retention rigorously. A clean 5-year cohort retention chart is worth six figures at the negotiation table. Most concierge practices don't track this formally, which is a mistake.

Raise your retainer. Mature concierge practices with strong renewals can typically raise retainers 5-10% every other year without meaningful attrition. A $500 retainer increase on 400 members is $200K of pure-margin revenue and directly adds $600K-$1M to enterprise value.

Build the practice brand, not yours. Shift marketing from "Dr. Smith" to "Highland Concierge Medicine." It feels wrong but it's the single most valuable thing you can do.

Get clean financials. Separate retainer revenue, insurance revenue, and ancillary revenue (labs, aesthetics, IV therapy) into distinct line items. Clean up your add-backs and document owner comp. Concierge buyers are sophisticated and appreciate professional presentation.

The Bottom Line

Concierge medicine is a real asset class now. Mature practices with affiliated brands and strong retention trade at 3.5-4.5x revenue, independents with premium retainers can clear 5-6x, and the ceiling is higher than almost anywhere else in primary care. The catch is that the things buyers care about — retention cohorts, brand separability, waitlist depth — aren't things most concierge physicians track. Start tracking them 24 months before you sell, and the valuation outcome shifts meaningfully in your favor.