This article originally appeared in the Summer 2025 issue of EquiManagement. Sign up here for a FREE subscription to EquiManagement’s quarterly digital or print magazine and any special issues.
Over the past decade, large corporate entities have been purchasing equine practices at an accelerating rate. The number of equine practitioners working for a national corporate chain of veterinary hospitals increased from 1% in 2016 to 4% in 2024, according to survey results from the 2016 AVMA/AAEP Equine Economic Report and the 2024 AVMA/AAEP Report on the Economic State of the Equine Veterinary Profession. Many of the largest equine hospitals are now corporately owned.
The Corporate Consolidator Model
In the equine sector, corporate rollÂups began in 2016 with the formation of Mixed Animal Veterinary Associates North America (MAVANA), when 21 mixed, companion, and equine practices merged into one entity. At MAVANA, 95% of the shareholders were practicing veterinarians, and most sold their practices for a portion of cash and a portion of equity in the new corporation. In January 2018, the nation’s oldest equine hospital, Hagyard Equine Medical Institute, joined MAVANA. In 2020, PetVet Care Centers bought MAVANA, a group of about 35 equine and mixed practices, for an undisclosed price.
National Veterinary Associates (NVA) entered the equine market by purchasing its first practice, Fairfield Equine, in Newtown, Connecticut, in late 2018. It acquired New-York-based Miller & Associates in May 2019. JAB Holding Company, a global private equity group, purchased a majority stake in National Veterinary Associates in August 2019. Since that time, NVA has split into two groups in response to Federal Trade Commission concerns.
Another entry to the equine field was Avanti Equine Veterinary Partners, which formed in 2017 and had acquired seven equine practices by the time the Altano Group purchased it in 2023. Based in Germany, the Altano Group includes equine clinics and practices in 10 countries.
The traditional model for equine veterinary practice acquisition in previous decades was for practice owners to sell some or all shares to one or more of their associate veterinarians. Occasionally, a veterinarian not employed by the clinic would buy an existing equine practice without first working as an associate, but this was fairly uncommon. The traditional model of practice sales is still more common than a corporate buyout because most equine practices are below the threshold that attracts the aggregators, but many practice owners struggle to arrive at a fair market value, where both the buyer and seller are willing to complete the transaction. In many cases, associates choose to simply start their own solo practices rather than pay large sums for an existing practice that will see its founder soon retire.
For a practice with a facility, at least three veterinarians, and earnings upward of $2 million, corporate consolidators will pay considerably more than the practice is worth when valued by traditional methods. This might mean a multiple of 15 compared to a traditional multiple of five. It’s no wonder practice owners choose this path. As practices grow, their owners, who are often nearing retirement, see a sale to a corporate buyer as hard to resist; the multiples offered can be three to four times that of an “inside” sale to an associate or group of associates.
The money to pay the huge multiples comes from a private equity aggregation model. A private equity firm (PEF) accumulates capital from institutions (such as pension funds or colleges) or high-value individuals, attracting their investment by promising a sure profit over a four-to-six-year period. To provide this return, the PEF must grow revenue and increase profitability in the practices they buy. When purchasing a practice, the firm offers the seller an exit strategy, staff recruitment, and back-office support, such as human resources, marketing, and bookkeeping. They do not provide local direct management, but instead appoint a hospital director, typically a senior veterinarian at the practice. This means management headaches remain, though decisions often now need to go up the chain of command to a regional director.
Perceptions and Satisfaction With Corporate Ownership
In the United Kingdom, almost 60% of veterinary practices, including equine, are corporately owned. In 2021, Jonathan Pycock, BVetMed, PhD, DESM, MRCVS, surveyed U.K. equine veterinarians to explore the effects of corporate ownership on equine practice. Respondents belonged to the Equine Veterinary Group (EVG), a discussion group open to all equine veterinarians working in the U.K. The findings indicated that corporate ownership tended to improve work-life balance and salary but produced an almost equal split between increased and decreased job satisfaction. About a third of respondents reported reduced client satisfaction, and almost half reported increased treatment costs to clients.
In their August 2023 JAVMA article about perceptions and satisfaction levels among veterinarians employed at corporate versus privately owned clinics, Lori R. Kogan, PhD, and Mark Rishniw, PhD, wrote, “One frequently touted positive aspect of working for a corporate-owned practice is the benefits package, including health insurance, paid vacation time, continuing education reimbursement, retirement, and paid sick leave. It has been suggested that consolidation can save money, thereby enabling corporations to offer more and better benefits. Yet the ability of corporations to increase employee benefits has not always translated into a reality, with some veterinary professionals reporting worse benefits after their practice transitioned to corporate ownership.”
When a national firm owns a group of practices—often geographically far flung—the initial challenges for the teams include integrating new systems, such as new practice management software, cloud storage, and vendor contracts. In addition, the corporate HR department might issue new employee handbooks, paid time off policies, health insurance plans, and possibly employee retirement plans, such as 401(k). All the corporately acquired hospitals in a company must be on the same systems and insurance plans to realize the economies of scale that will increase profit. Change is always difficult, especially if a practice has been comfortably successful for many years with its current systems.
The Kogan and Rishniw study’s findings showed satisfaction levels for multiple work-related factors were higher for veterinarians in private versus corporate practices: “Participants in private practice reported higher satisfaction with: feeling known as an individual by upper management, hospital culture, the ability to fire difficult or abusive clients, and mentorship. In addition, those in corporate practices reported feeling more pressure than those in private practice to generate revenue and see more clients per shift. Together, these elements suggest that participants working in private practices feel more supported than their colleagues in corporate practices.” Of the 896 respondents, 55% indicated a preference for working in private practice compared to 12% preferring corporate practice.
Many, if not most, equine veterinarians are independent and like to have flexibility, autonomy, and self-determination that might not be present in a corporate environment. In November 2024, Kit Miller, DVM, who sold most of his practice to NVA in 2019, sued his corporate partner for $9 million for breach of contract, stating in the complaint that NVA “changed the policies, processes, and procedures of the practice, making it less collaborative, less collegial, and a less desirable place to work.” It remains to be seen how this case will be settled.
Typically, consolidators acquire a practice for a multiple of 10-20 times EBITDA (earnings before interest, taxes, depreciation, and amortization), then over a four- to five-year period, push to increase the revenue and decrease the expenses. Because it takes a similar amount of energy to run a practice grossing $10 million as it does to run one grossing $1Â million, aggregators naturally seek out bigger practices. After a year or two, the corporate managers need the practices they purchase to bring profits to at least 20%, so pressure might intensify to rein in wages and increase prices for services. During this phase, requests for new equipment or additional staff are often denied, as efficiency and high productivity from existing assets increase profit more than capital investment. Because the original private equity Âinvestors must receive the promised 20-30% return on investment in a prescribed number of years, the next sale of the practice to a bigger conglomerate might occur at this point to provide the cash for the return on investment.
Often, clients don’t immediately realize a corporate entity has bought the practice that has cared for their horses for years. Most times, nothing changes about the practice name or the veterinarians who work there—at first. But in many cases, prices for services increase, sometimes sharply, and within a few years some of the most trusted, experienced doctors exit, including the practice owners who have sold their shares for a handsome price. After years of hard work, the owners reap a reward for their effort and can enjoy a very comfortable retirement or even open a new practice in another area if they still want to work in the industry.
Although it stands to reason that compensation is higher in corporately owned practices, the 2024 AVMA/AAEP Economic Report said when using a solo practitioner’s compensation as the reference point, those working in group practices owned by a single veterinarian earned $60,835 more than the solo, and those working in group practices owned by a national corporately owned group practice earned $54,199 more. However, offers from large corporate firms more commonly include generous signing bonuses.
The Pros of Corporatization
Corporate veterinary ownership has advantages compared to the traditional private practice model. Many veterinarian owners dislike the business management part of running a practice or simply lack the skills to effectively deal with staffing issues, hiring new employees, ensuring compliance with regulatory issues, and other time-consuming business details. Unfortunately, the local hospital manager is often tasked with much of this work, although they will have support from corporate regional managers. Sometimes associates in corporate practice work more standardized schedules, with fewer hours than doctors in other practices. Because they have many employee veterinarians, corporately owned practices can sometimes send a relief veterinarian in the case of an injury or maternity leave.
As an exit strategy, selling to a corporate aggregator can allow a practice owner nearing retirement to gain a much higher sale price than they could from an inside sale to an associate. The corporate practice will usually keep existing staff members and require the selling owners to continue working for several years as employees as a condition of sale. In addition, because equity venture groups do not typically buy practice-associated real estate, the former practice owner might benefit financially by leasing the practice facility to the corporation long-term. For retiring practice owners, the benefits of selling to a corporate entity are clear.
Although associate equine practitioners understand the lure of a big payout for practice owners, they lament the change in the industry. As one said, “I understand the concept of an owner that wants an exit plan that pays off in a big way, but it sacrifices the futures of the younger veterinarians coming behind.” The sharp increase in the number of solo equine practices seen in the 2024 AVMA/AAEP Economic Report might illustrate associates’ recognition of the considerable financial benefits of practice ownership.
Take-Home Message
In summary, corporate ownership of equine practices has allowed veterinarian owners to retire more comfortably than ever and has likely been a factor in the proliferation of small practices owned by former associates. Some corporate practices struggle to retain associates long-term, which is a negative factor for clients, who typically value individual relationships with their horses’ primary veterinarian. In addition, horse owners of limited means might be unable to afford care as prices rise. The noncompetition clauses in some corporate practices’ employment contracts can limit associates who have spouses employed and children in school locally from continuing to stay in equine practice. To avoid uprooting their families, they often shift to companion animal positions. It is uncertain what the future will hold, but it seems likely that global corporate firms will continue to purchase large practices.Â
One Veterinarian’s Experience With Corporate Ownership
Julia Petersen, DVM, MBA, Managing Veterinarian at Bayhill Equine, an NVA practice located in Redwood City, California, shared the following information about the practice’s experience with corporate ownership:
Q: What were the most positive aspects for the practice’s veterinarians and staff after the transition to large corporate group ownership?
A: The most positive aspects are better benefits, including things like liability insurance, HR support, financial benefits like 401(k), child care, and performance bonuses as well as the ability to have top-of-the-line equipment and vehicles.
Q: What were the most negative aspects for the practice’s veterinarians and staff after the transition to large corporate group ownership?
A: The most negative aspects are the required uniform email and medical record software platforms and occasionally the required policy platforms for things like accounting and bill paying.
Q: What has been the most difficult thing for you about the transition?
A: The most difficult part was to trust and build a relationship with a separate management team that we didn’t know. We didn’t know their team, much less did we know what to actually expect from their management style and expectations for the practice.
Q: What changes in operation occurred right away? Were there additional changes after the dust settled?
A: Very few changes in operation occurred right away; it wasn’t until at least a year later that corporate decided to streamline and “corporatize” anything. Most of the changes were made gradually over several years.
Q: What has it been like for the clients? Pros? Cons?
A: The majority of the clients to this day don’t even know that we are corporate-owned. The only con is more with vendors we work with that now have a bit of a delay in getting paid, and it is a bit more complicated than it used to be.
Related Reading
- Starting Your Own Equine Practice
- Careers in Veterinary Industry and How to Pursue One
- Understanding the Next Generation of Veterinarians
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