2026 Infusion Services M&A Market Update: Site of Care Shift Drives Consolidation and Strong Buyer Demand

Infusion services have become one of the most actively pursued areas in healthcare services, attracting significant investment from both private equity and strategic acquirors. A structural shift in where services are delivered, a deep pipeline of infusible specialty drugs, as well as a highly fragmented landscape and benefits of purchasing with scale continue to drive buyers to aggressively pursue ambulatory infusion centers, infusion suites and home infusion providers.
Many infusion patients manage chronic conditions such as multiple sclerosis, rheumatoid arthritis and Crohn’s disease, and return for treatment on a recurring schedule. The setting where those high-cost drugs are administered has a meaningful impact on what payors spend. As payors push infusions out of the hospital and into lower-cost settings, ambulatory infusion centers, ambulatory infusion suites and home infusion providers are well positioned to capture that infusion volume. These broad infusion market tailwinds continue to drive transaction activity within the infusion sector.

PGP has relationships with numerous private equity investors and strategic buyers actively pursuing infusion acquisitions who estimate that 40% to 60% of infusion volume remains in hospital and health system settings. The same treatment can cost significantly less when delivered in a freestanding center, physician office or the patient’s home. This cost gap between hospital and other settings sits at the center of the investment thesis as large commercial payors, including UnitedHealthcare and Aetna, have adopted site-of-care policies that restrict reimbursement for hospital-based infusions when a lower-cost setting is clinically appropriate.¹ This infusion volume leaving hospital settings must go somewhere. Infusion business operators describe the infusion market as wide open, with more referrals coming into their centers than they can currently absorb.

New drugs are also adding to infusion demand. Many of the specialty drugs coming to market are biologics given by infusion, particularly in neurology, rheumatology, gastroenterology and allergy, which are the specialties that already account for most infusion volume outside of oncology. The 2024 approval of Kisunla, a monthly infusion for early Alzheimer’s disease, is a recent example. ³

The infusion market also remains highly fragmented as most infusion capacity sits with regional operators, single-site centers, small home infusion pharmacies and physician practices that infuse in their own offices. Based on PGP’s proprietary research very few independent platforms exceed $10 million of revenue on an annual basis. This fragmentation has allowed consolidators to utilize targeted acquisition strategies to bolster their platforms’ service areas and specialties as most platforms pursue a healthy mix of both acquisitive growth and de novo center openings. The infusion market has also witnessed several “blockbuster” transactions as of late, most recently October 2026, where Clayton, Dubilier & Rice and McKesson announced the agreement to acquire Option Care Health, a leading independent provider of home and alternate-site infusion services, in a transaction valued at approximately $5.8 billion.

For independent infusion operators and physician practices, demand for infusion has been very strong, but the economics are getting harder to manage alone. Drug margin is the profit engine of an infusion business, and protecting it requires purchasing scale, strong payor contracts and the ability to absorb drug pricing changes. Buyers have noted to PGP that some physician groups have reconsidered their in-office infusion programs as working capital requirements and administrative demands have increased. A private equity or strategic partner can help address these pressures by pooling drug purchasing across sites, strengthening payor contracts and billing, and providing the capital to open new centers.

Infusion businesses vary significantly in their operating structures, financial profiles, and reimbursement dynamics. Each business model has distinct characteristics that influence profitability, reimbursement opportunities, and attractiveness to potential buyers. The industry can generally be divided into three primary operating models:

• Ambulatory Infusion Suites (AIS): Infusion chairs run by a home infusion pharmacy, usually in or next to the pharmacy. Instead of sending a nurse to each patient’s home, the pharmacy brings patients to the suite, so one nurse can treat several patients at once. Suites bill the way a pharmacy does, for the drug plus nursing and supplies. Ambulatory infusion suites operated by home infusion pharmacies generally rely heavily on commercial reimbursement. Traditional Medicare coverage for drugs and administration furnished in a pharmacy-operated suite is limited, although coverage may be available through a separately structured physician- or practitioner-based setting when applicable Medicare requirements are met.
• Ambulatory Infusion Centers (AIC): Freestanding outpatient centers are overseen by a physician or advanced practice provider. Centers buy the drug themselves and bill it under the patient’s medical benefit, known as buy and bill. Appropriately structured and enrolled centers may be able to bill Medicare and commercial payors for covered drugs and services, subject to applicable billing, supervision and coverage requirements. Centers mostly treat high-cost specialty biologics given on a recurring schedule.
• Home Infusion Services: A pharmacy prepares the drug, and a nurse gives it in the patient’s home. Home infusion covers the widest range of therapies, from IV antibiotics and nutrition to immune globulin and specialty biologics. Commercial plans broadly cover home infusion, but Medicare coverage is limited. Home-based therapy typically carries shorter treatment plans but benefits from higher margins. Treatment is administered by a nurse that is either hired or contracted by the service company.

A fourth setting, the physician office, remains an important part of the market and an area of focus for PGP. Many rheumatology, neurology, gastroenterology and allergy practices operate infusion suites as an ancillary service within their clinical footprint. In some cases, that infusion ancillary has grown into a business of its own, and buyers increasingly view a well-run physician infusion suite as an asset that can be carved out, partnered or expanded.

The lines between the three infusion business models are blurring. Operators are starting to combine suites, centers and home infusion so they can treat each patient in the most appropriate and cost effective setting regardless of payor. Today, few national players do both center based and home-based infusions at scale. Multiple buyers PGP has spoken with expect more platforms to combine home- and center-based capabilities over the next several years, as operators seek to serve patients across settings and create opportunities for purchasing and operational efficiencies. Home infusion businesses have historically traded at a slight discount to center based businesses, reflecting shorter, more acute courses of therapy, larger share of lower cost drugs, and a history of staffing challenges common in home-based care settings.

Infusion businesses exhibiting the characteristics outlined below may be well-positioned to command premium valuation multiples in the high-single-digit to low-double-digit range. The most common red flag is concentration risk, whether in a single drug or a single referral source, while payor mix on its own tends to be less of a concern, since buyers recognize it largely reflects the local market. Buyers evaluate infusion businesses through a combination of drug economics, reimbursement, clinical operations and growth potential. For many buy-and-bill providers, the spread between drug reimbursement and acquisition cost is a significant driver of profitability. Buyers also assess administration reimbursement, staffing costs, working capital requirements and the durability of the business’s therapy and referral mix. Buyers looking to pay a premium valuation focus on the following:

• Net Drug Margin per Treatment: Private equity and strategic buyers consistently describe net drug margin per treatment as the single most important metric in the business because it is the part an operator can actually control.
• Specialty and Therapy Mix: Referrals from neurology, rheumatology, gastroenterology and allergy, which prescribe higher cost infusible therapies, paired with a diverse drug portfolio. Beyond specific drugs, buyers look for a healthy drug mix, ensuring no single therapy type accounts for outsized portions of company revenue.
• Diversified Referral Network: A broad base of referring physicians who send patients because of convenience and patient experience.
• Scale and Capacity: Multiple sites, efficient chair utilization, and the ability to add capacity. Most centers operate four to six chairs, and buyers place real value on a model that can replicate new center openings.
• Payor Contracts and Reimbursement Infrastructure: In-network contracts with major commercial payors, approvals secured before each treatment, and a billing team that reliably collects on expensive drug claims.
• Compliance: Accurate billing and documentation, the right physician or nurse practitioner supervision under state rules.

Buyers are equally clear about what reduces value. The most common red flag is concentration risk, whether in a single drug or a single referral source, while payor mix on its own tends to be less of a concern, since buyers recognize it largely reflects the local market.

Scale is another critical factor in determining the universe of potential buyers. Healthcare private equity firms typically seek infusion businesses generating at least $3 million in EBITDA when evaluating an investment as a new platform acquisition. However, established strategic buyers or private equity-backed platforms with existing infusion operations are often willing to pursue significantly smaller businesses, viewing the acquisitions of smaller infusion businesses as opportunities to expand their geographic footprint, strengthen regional density, or establish a new regional hub.

Businesses exhibiting the characteristics outlined above may be well-positioned to command premium valuation multiples in the high-single-digit to low-double-digit range.

Because drug margin drives the economics of an infusion business, changes in drug pricing and payor policy flow directly to earnings. Buyers will evaluate each of the following, and infusion business owners who understand their exposure before going to market are in a much stronger position to defend their value:

• Biosimilar Conversion: When a cheaper biosimilar replaces a brand name drug, providers earn less on each treatment. The infusion sector experienced biosimilar conversion with Stelara, and more drugs are expected to follow.
• Medicare Drug Price Negotiation: Starting in 2028, Medicare will pay lower, negotiated prices for several infused drugs, including Entyvio, Orencia, Cimzia and Botox.[2] Since providers are paid a percentage on top of the drug’s price, a lower price means less profit per treatment. Entyvio and Orencia are core drugs for many GI and rheumatology infusion businesses.
• White Bagging: Some payors require certain drugs to be shipped from a pharmacy they choose instead of being bought by the provider. The provider still administers the infusion but loses the profit on the drug.

While reimbursement and drug pricing risks are part of buyer underwriting, they also highlight the potential benefits of scale and diversification. Larger platforms have the purchasing power and payor relationships to absorb pricing changes that can meaningfully impact a single site operator or a physician practice infusing in its own office. Having a wide array of therapies is another crucial strategy to avoid concentration risk associated with biosimilar conversion, Medicare drug price negotiation and white bagging.

The buyer universe for infusion businesses is broad and becoming increasingly competitive. Each buyer has a different growth strategy, and understanding those differences can help sellers evaluate valuation, deal structure and the future role of providers and management.

Ambulatory Infusion Center and Suite Platforms

There are several types of strategic platforms operating across the infusion market. The largest group is ambulatory infusion center platforms, which operate physician supervised centers that buy and bill drugs under the medical benefit. Ambulatory infusion center platforms grow through a mix of acquisitions and new center openings, with some sponsors describing a roughly even split between the two. Some have also added their own specialty pharmacy to pool drug purchasing across their centers and improve drug margin. Selected platforms include:

Home and Omnichannel Infusion Platforms
A second group of platforms is built around home infusion and specialty pharmacy. Some remain focused on treating patients at home, while others have added infusion suites, and in a few cases centers, so they can treat more patients in one location. Several sponsors have used a home infusion pharmacy as their starting point. The most active groups are as follows:

Physician Practice Focused Platforms

In physician specialties where infusion therapy is more common (neurology, GI, rheumatology and allergy), some providers have taken it upon themselves to build out in-office infusion locations. Infusion service lines function as ancillary services to the physician’s practice. When infusion is a smaller service line, buyers often carve out the infusion business or open a new center nearby and partner on referrals. Some platforms have acquired specialty practices outright, including Vivo Infusion (Neurology Institute of San Antonio), Horizon Infusions (Advanced Rheumatology and Arthritis Research Center) and more.

National Strategics and Payors

Some of the largest infusion providers in the country are owned by large healthcare companies and payors, including Option Care Health (transaction with CD&R and McKesson expected to close in 2027), Optum Infusion Pharmacy (UnitedHealth Group), Paragon Healthcare (Elevance Health) and Amerita (BrightSpring Health Services). National strategics and payors are more selective and tend to pursue larger regional infusion businesses that add geography or capabilities. Several of the national infusion providers are owned by the payors that set site-of-care policies, making them both a source of patient volume and a direct competitor for independent infusion operators.

Which Healthcare Private Equity Buyers Are Pursuing Infusion Businesses?

PGP has interfaced with a broad range of private equity buyers that are actively looking for new infusion platforms. Despite the number of existing platforms, sponsors continue to raise new funds and pursue new starting points, and several are willing to consider infusion businesses slightly smaller than historical platform investments if the management team and drug margin profile are strong.

Given PGP’s broader focus on physician services and outpatient ancillaries, the firm has longstanding relationships and experience transacting with many of the private equity and strategic buyers that invest in infusion businesses. PGP has also seen growing interest from owners of independent infusion centers and suites, as well as physician practices with established infusion services, that are evaluating how to capture the value of their businesses, whether through a full sale, a partnership, or a carve-out of the infusion business. The table below highlights select transactions involving ambulatory infusion centers, infusion suites and home infusion providers. Deal activity has been steady through 2025 and 2026, led by add on acquisitions from established platforms and a wave of new platform formations.

PGP believes infusion services represent an attractive sector for infusion business owners considering a sale or partnership. Infusion volume continues to shift out of the hospital, with payors helping to push it through site of care policies, and a deep pool of private equity and strategic buyers is competing for the businesses that are well positioned to capture it.

Independent infusion operators and physician practices with established infusion service lines have an opportunity to achieve premium valuations, particularly those with strong drug margin and a diverse drug portfolio and referral base. Looking ahead, PGP expects the next 12 to 24 months to bring continued add on acquisitions and new platform formations, along with increased secondary buyout activity as several first-generation infusion platforms approach the end of their investment cycle. At the same time, the challenges of remaining independent continue to grow, driven by biosimilar conversion, Medicare drug price negotiation, payor specialty pharmacy mandates and the purchasing scale needed to protect drug margin.