Uncover Hidden Liabilities and Validate Operational Scalability

Success in healthcare transactions requires a dual perspective. Coker’s Financial & Operational Due Diligence combines rigorous financial analysis with deep operational insights to provide a 360-degree view of deal value, identifying risks that exist both on the balance sheet and within the clinic walls.

We help buyers and sellers move beyond the numbers to understand the "how" behind the performance. Our experts pinpoint operational inefficiencies, labor risks, and infrastructure gaps that directly impact future earnings and post-close integration..

Trusted by healthcare organizations nationwide

  • 35+ years of healthcare consulting experience
  • Deep expertise in Quality of Earnings (QoE) and EBITDA normalization
  • Proven track record supporting private equity, strategic buyers, and sellers
  • Integrated Financial & Operational Due Diligence approach
  • Insights grounded in regional and national healthcare benchmarks
"[Coker] has been a trusted advisor for over three years. The introduction of their cloud-based business intelligence solutions has allowed us to become a more data-driven organization. We look forward to our extended partnership and future collaboration."

- Steve Fischer, Chief Executive Officer at Escambia County Health Care Authority

 

35+

Years of healthcare industry experience

120+

   Nationwide consultant network

80+

Books written and published

 When Operational Reality Meets Financial Performance

A strong EBITDA is only as good as the operations supporting it. In healthcare, hidden operational risks—such as high provider turnover, aging IT infrastructure, or inefficient revenue cycle workflows—can quickly erode the value of a deal after the ink has dried.

Coker’s Financial & Operational Due Diligence team bridges the gap between the ledger and the front office. We provide the clarity needed to validate that a target's operational structure is not just stable, but scalable.

 

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Financial & Operational Due Diligence Services

Financial Due Diligence (FDD)
Comprehensive analysis to determine sustainable earnings, normalize EBITDA, and assess true cash flow durability. We evaluate revenue quality, payer mix, reimbursement trends, working capital needs, and financial risk exposure.

Quality of Earnings (QoE) Analysis
Detailed review to identify non-recurring, non-operational, and owner-specific adjustments — ensuring valuation is based on defensible, normalized performance.

Operational Due Diligence (ODD)
In-depth assessment of clinical operations, staffing models, provider productivity, scheduling, revenue cycle effectiveness, and scalability of processes.

Revenue Cycle & Reimbursement Assessment
Evaluation of billing accuracy, coding integrity, contractual adjustments, bad debt policies, and exposure to regulatory or reimbursement changes.

  • Objective Financial Insight

    Independent, data-driven analysis grounded in healthcare-specific benchmarks and transaction experience.

  • Operational Visibility

    We explain not just what the business earns — but why it performs that way and whether results are sustainable post-close. 

  • Risk Identification & Mitigation

    Early identification of reimbursement risk, provider dependency, compliance exposure, and scalability constraints that could impact deal value.

  • Responsive Partnership

    Direct access to senior advisors who understand the urgency of your deal.

Trusted Advisors in Healthcare Due Diligence

Coker brings more than 35 years of healthcare transaction and advisory experience to every engagement.
Our Financial & Operational Due Diligence team combines financial, clinical, and operational insight to help buyers and sellers validate valuation, uncover risk, and identify sustainable performance drivers. We go beyond confirming numbers—we deliver clarity that supports confident decision-making and post-close success.

Dual Perspective

Analyzing deals through both financial and healthcare-specific operational lenses.

Integrated Advisory Team

Our specialists work together to create sustainable value-creation plans post-transaction.

Independent and Defensible

Objective, data-driven diligence supported by transparent findings that quantify risk and validate opportunity.

Healthcare Specialization

Deep understanding of the unique regulatory and clinical nuances that generic firms miss.

A Proven, Transparent Due Diligence Process

Our due diligence process delivers clarity and confidence, designed to evaluate sustainable earnings, operational readiness, and value-creation opportunities in healthcare transactions.

  1. Financial Review & Quality of Earnings Analysis

    We normalize EBITDA, assess revenue sustainability, evaluate payer mix, and identify non-recurring or owner-specific adjustments impacting valuation.

  2. Operational Performance Assessment

    We review clinical workflows, staffing models, provider productivity, revenue cycle effectiveness, compliance infrastructure, and IT systems to determine scalability and execution risk.

  3. Risk & Opportunity Identification

    We quantify financial and operational risks while identifying practical opportunities for margin improvement and operational optimization.

  4. Transaction Alignment & Post-Close Readiness

    We align diligence findings with the investment thesis to support valuation validation, integration planning, and long-term performance improvement.