Blog: The Easy Money Is Gone. Here’s What Capital Wants Now. 

Elevate’s capital panel on what closes deals in 2026, the K-shaped market, and where operators still hold leverage. 

A few years ago, behavioral health deals rode a rising tide. Census growth, credible EBITDA margins, and a compelling mission were often enough to get to close. Tani Weiner, Principal of Polsinelli put it plainly at Elevate 2026: that ship has sailed. 

The panel, moderated by AltercareLine CEO and Founder Michael Castanon, brought together an M&A attorney, a sell-side advisor, and a real estate investor with a $1.4 billion portfolio built entirely on behavioral health. They agreed completely on one point: buyers are pricing risk more carefully than ever, and the operators who thrive will be the ones who can show their math. 

Two years ago, a chart and coding review was a “sometimes.” Today Tani considers it standard on every deal. Buyers want to know how your documentation measures up to payer standards and whether the business runs on something durable rather than what she called a sugar high. 

Dan Davidson of NorthBorne Partners added that many CEOs underestimate how much a deep management team matters, and he has a vivid way of putting it: selling a business without one is like trying to change your tires at 70 miles an hour. When buyers find an outsourced accountant where a CFO should be, they price it in, so the money saved on a thin team tends to cost more at close. Build the bench before you go to market. 

Tani described the landscape as a K. On the upward arm sit operators with validated performance, healthy payer relationships, charts that survive an audit, a sustainable revenue cycle, and technology on par with what payers now use to review claims. On the downward arm are organizations trying to do too many things that don’t fit together, spending just to keep the ship afloat. 

The space between is where it gets interesting. Turnaround opportunity is growing there, and operators with real know-how bring benefits beyond cash, like the ability to step in, stabilize, and get a facility to revenue faster than an outside investor could. 

Concentration in a single payer or referral source is what Dan called a haunted house of cards. Rick Coley of Scioto Properties is watching accounts receivable climb at struggling operators as payers scrutinize claims line by line. And Tani is seeing arcane issues like corporate practice of medicine derail deals that would have sailed through two years ago. 

If a CEO has $10 million in dry powder today, what’s the better bet: a struggling competitor at a discount, or technology and data infrastructure? Rick’s answer is to invest in your tech. Dan’s was conditional. If your RCM, back office, and payer relations are already tight, an acquisition can be the faster path to growth. If they aren’t, it’s catastrophic. 

Tani’s closing advice applied to every question on the panel. Figure out who you really are, and be that. 

Watch the full session for the real estate discussion, including when a sale-leaseback works as a growth lever rather than an emergency tool, and why second-generation space is winning out over greenfield development. 

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About the Authors

Travis Moon Travis Moon, Kipu's Content Marketing Strategist, is a seasoned leader in healthcare IT and content marketing, specializing in the behavioral healthcare sector. He develops impactful, data-driven campaigns that support healthcare professionals and enhance patient outcomes. With over a decade of experience, Travis has led strategic content initiatives for major healthcare organizations, including the launch of data visualization tools and thought leadership campaigns.