📖 Approx. 5 minutes ／ Updated May 5, 2026
1. Three Patterns of Clinic Real Estate
The M&A handling differs for each of the following: ① Individually owned (by the representative director), ② Owned by a medical corporation, and ③ Leased from a third party.
2. In Case of Individually Owned Real Estate
It is common for the real estate to remain individually owned after the M&A and be leased to the medical corporation. The rental fee is generally set based on market value.
3. In Case of Medical Corporation Owned Real Estate
The business is succeeded along with the management rights through the transfer of equity. Confirm the tax implications for fixed asset tax and registration license tax.
4. In Case of Leasing from a Third Party
Clarify in the contract the lessor’s consent, conditions for lease transfer, and handling of security deposits.
5. Real Estate Valuation
Valuation is calculated by combining factors such as the road frontage value, fixed asset tax appraisal value, and real estate appraisal value.
6. M&A Medical’s Real Estate Collaboration Support
We provide valuation and negotiation support in collaboration with affiliated real estate agents.
Start with a Free Consultation
For consultations regarding medical business succession or M&A, please contact M&A Medical, specialists in the healthcare industry. Reach out via our contact form or our 60-second free preliminary assessment to take the first step. We are an M&A support institution certified by the Small and Medium Enterprise Agency, operate on a success-fee basis (no upfront fees), offer nationwide service, and handle all consultations with strict confidentiality.
Key Takeaways of the Article
Clinic real estate falls into three patterns: individually owned, medical corporation owned, or third-party leased. The M&A scheme differs for each, raising issues related to rent setting, ownership transfer, and lease contract succession.
Latest Trends in the Medical M&A Industry
Since 2020, the number of business succession M&A deals in Japan’s healthcare industry has rapidly increased. 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%. Meanwhile, 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.
- Succession Demand for Clinics: Over 1,000 M&A and business succession deals occur annually (estimated)
- Trend Towards Medical Corporationization: Increasing cases of succession after transitioning from individual practice to a medical corporation
- Diversification of Potential Buyers: Medical corporation groups, business companies, physicians with independent practice aspirations, funds, etc.
- Impact of Regulatory Changes: Revisions to the Medical Care Act, extension of the certified medical corporation system, and medical fee revisions influence succession strategies
Considering 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 plan and prepare the following systematically:
- ☑ Determine desired retirement date (M&A takes 6-12 months)
- ☑ Organize financial information 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 by the clinic or leased)
- ☑ 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 signing 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):
- Case A: Urban Clinic – A clinic with a 70-year-old 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 succeeded by a neighboring medical corporation, ensuring the continuation of regional medical services. This was achieved through collaboration with a physician returning to the area.
- Case C: Strategic Acquisition – A 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 reconciled 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. What should I do first?
We recommend starting with a free consultation. We offer consultations with anonymity and strict confidentiality, proceeding step-by-step from understanding your current situation to providing a preliminary assessment of market value and matching you with potential buyers. We also welcome consultations for 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 if I proceed with an M&A?
Information leakage is a major risk. M&A Medical requires NDAs (Non-Disclosure Agreements) from the initial stages and limits the number of involved parties. Staff notification typically occurs after the Letter of Intent (LOI) or just before the final contract, and we take utmost care to ensure the process remains confidential from the clinic staff until the transaction is executed.
Q. How much does it cost?
M&A Medical operates on a complete success-fee basis. Initial consultations, preliminary assessments, and introductions to potential buyers are entirely free. Fees are only charged upon successful completion of the sale, based on a predetermined commission rate (3-5% of the transfer price, using the Lehman formula). There are no upfront fees, monthly charges, or interim payments.
Related Articles & Services
Please also refer to the following articles in conjunction with this one:
- Complete Guide to Business Succession for Hospitals and Medical Corporations
- Complete Guide to Selling or Transferring a Clinic
- Solutions for Clinics Facing a Shortage of Successors
- Step-by-Step Guide to Medical M&A
Information on Free Consultations & Preliminary Assessments
For consultations regarding medical business succession and M&A, please feel free to contact M&A Medical, specialists in the healthcare industry. As an M&A support institution certified by the Small and Medium Enterprise Agency, 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
- ✅ Specializing in the Healthcare Industry – Nationwide Service
- ✅ Complete Success Fee Basis (No Upfront Fees, No Monthly Fees, No Interim Payments)
- ✅ Strict Confidentiality Assured with NDA Signing
- ✅ Anonymous Consultations & Free Preliminary Assessments Available
Please take the first step by contacting us via the Contact Form or the 60-Second Free Preliminary Assessment.