📖 Approx. 5 minutes ／ Updated May 5, 2026
1. Main M&A Brokerage Fees
The four common types are retainer fees, monthly fees, interim fees, and success fees. The combination of fees varies by company.
2. Risks of Retainer Fee Structures
Hundreds of thousands of dollars are incurred in the early stages of consultation. Since refunds are not provided even if the deal is not closed, careful selection is necessary.
3. Benefits of Success Fee Structures
Zero cost until closing. Minimizes risk for the seller. M&A Medical also uses this structure.
4. Lehman Formula Calculation
Calculated based on rates according to the transfer price. Generally, a decreasing rate system such as 5% (up to 500 million JPY) / 4% (500 million to 1 billion JPY) / 3% (over 1 billion JPY).
5. Handling of Interim Fees
Interim fees paid at the time of the Letter of Intent (LOI). It is necessary to clarify in the contract whether it will be deducted from the final fee after closing or added separately.
6. M&A Medical’s Fee Structure
Completely success-based fee system (0 JPY retainer, 0 JPY monthly fee, no interim fees). Clear fee structure based on the Lehman Formula.
Start with a Free Consultation
For consultations on medical business succession and M&A, please contact M&A Medical, specialists in the medical industry. Please take the first step through our contact form or our 60-second free simple appraisal. We are a government-certified M&A support institution, operate on a success fee basis (0 JPY retainer), offer nationwide services, and handle consultations with strict confidentiality.
Key Takeaways
M&A brokerage fees are a combination of retainer, monthly, interim, and success fees. A complete success fee system (0 JPY retainer) minimizes seller risk. The Lehman Formula (3-5% of transfer price, decreasing with deal size) is the industry standard.
Latest Trends in the Medical M&A Industry
Since 2020, the number of business succession M&A deals in Japan’s medical industry has been rapidly increasing. According to a survey by the Japan Medical Association, the average age of practicing physicians exceeds 60, with an estimated successor shortage rate of around 40%. On the other hand, demand for succession by medical corporations and corporate groups is also expanding, leading to a record number of matching opportunities for both sellers and buyers.
- Demand for Clinic Succession: Over 1,000 M&A and business succession deals occur annually (estimated)
- Trend Towards Medical Corporation Formation: Increasing cases of succession after transitioning from individual practice to a medical corporation
- Diversification of Potential Buyers: Medical group corporations, business companies, ambitious employed physicians, fund-related entities, etc.
- Impact of Regulatory Changes: Amendments to the Medical Care Act, extension of the certified medical institution system, and revisions to medical fee schedules influence succession strategies
In light of these industry trends, early information gathering, expert consultation, and strategic timing are key to success.
Succession Preparation Checklist
To ensure a successful business succession or M&A, please prepare the following systematically:
- ☑ Determine desired retirement date (M&A takes 6-12 months)
- ☑ Organize financial status for the last 3 fiscal years (financial statements, tax returns)
- ☑ Create a list of medical equipment and facilities (including lease agreements)
- ☑ Organize staff structure and salary levels
- ☑ Confirm real estate information (owned or leased clinic)
- ☑ Organize desired transfer conditions (price, staff treatment, handover period)
- ☑ Consider tax schemes (consult with your tax advisor)
- ☑ Gain agreement from family and spouse
- ☑ Select a reliable M&A advisor
- ☑ Establish a system for executing Non-Disclosure Agreements (NDAs)
Actual Support Examples
Examples of business succession and M&A cases supported by M&A Medical (partial, details omitted due to confidentiality agreements):
- Case A: Urban Clinic – A 70-year-old clinic director, facing a lack of successors, was transferred to a medical corporation group. All staff were retained, and patient care continued. The process from consultation to closing took approximately 8 months.
- Case B: Rural Clinic – The region’s only clinic was sustained through succession by a nearby medical corporation, facilitated by collaboration with a returning physician.
- Case C: Strategic Acquisition – An employed physician planning a new practice acquired an existing clinic with a favorable location, staff, and licenses. They began operations within six months, saving approximately two years compared to starting a new practice.
In each case, we balanced the desired conditions of both the seller and buyer, carefully addressing industry-specific issues such as continuity of care, licenses, and staff treatment.
Frequently Asked Questions (FAQ)
Q. I am considering selling my practice. Where should I start?
We recommend starting with a free consultation. We accept consultations anonymously and with strict confidentiality, proceeding step-by-step from a needs assessment to a simple appraisal of the market value and matching with potential buyers. We also welcome consultations from those who simply want to “know the market price” or “consider future options” before making a decision.
Q. Will my staff and patients find out about the M&A process?
Information leakage is a major risk. M&A Medical executes NDAs (Non-Disclosure Agreements) from the initial stages and limits involvement to the minimum necessary parties. Staff notification typically occurs after the Letter of Intent (LOI) or just before the final agreement, and utmost care is taken to ensure the process remains confidential from the clinic staff until the transfer is executed.
Q. How much does it cost?
M&A Medical operates on a complete success fee basis. Initial consultations, simple appraisals, and introductions to potential buyers are entirely free. Fees are only incurred upon successful transfer, calculated according to our standard commission rates (3-5% of the transfer price, based on the Lehman Formula). We charge no retainer fees, monthly fees, or interim fees.
Related Articles & Services
Please also refer to the following articles in conjunction with this one:
- Complete Guide to Hospital and Medical Corporation Business Succession
- Complete Guide to Selling or Transferring a Clinic
- Solutions for Clinics Facing Successor Shortages
- How to Proceed with Medical M&A: A 6-Step Guide
Information on Free Consultations & Simple Appraisals
For consultations regarding medical business succession and M&A, please feel free to contact M&A Medical, specialists in the medical industry. As a government-certified M&A support institution, we design M&A deals that create long-term value for both sellers and buyers.
- ✅ Certified M&A Support Institution by the Small and Medium Enterprise Agency
- ✅ Specialists in the Medical Industry & Nationwide Service
- ✅ Complete Success Fee System (0 JPY Retainer, 0 JPY Monthly Fee, No Interim Fees)
- ✅ Strict Confidentiality with NDA Execution
- ✅ Anonymous Consultations & Free Simple Appraisals Available
Please take the first step through our Contact Form or our 60-Second Free Simple Appraisal.