About the Company

US Heart and Vascular (USHV) is a Franklin, Tennessee-based healthcare company that serves independent cardiology practices. The private equity-backed company provides its partner practices with centralized back-office services like accounting, financial services, and IT, as well as capital and other resources so that they can focus on delivering excellent patient care. Each acquired practice keeps its own branding but is otherwise fully integrated within USHV. Founded just four years ago in 2021, the firm has expanded rapidly, growing from 50 partner physicians in its first year to more than 200 across five different states in 2025. 

Challenges

In a field as heavily regulated as healthcare, due diligence is a major undertaking. USHV worked with a third-party provider to handle the high volume of diligence requests, which spanned everything from finance and legal questions to chart audits and compliance concerns. With so many items to confirm, requests can quickly become fragmented and hard to track.

For an inexperienced seller, often the owner of USHV’s target practices, these scattered requests quickly became overwhelming. In addition to managing their regular day-to-day duties, the sellers had to deal with a barrage of diligence questions across multiple streams, requiring a lot of time and causing critical requests to fall through the cracks.  

There was no central location for stakeholders to view all requests, and important diligence information was spread across Excel, email, and internal chat. With no way to filter the requests by relevant streams, sellers were confused about who was responsible for answering which requests and when. It also meant constant “re-asks” for practice data leading to wasted time and resources. 

Negative Business Impacts

Slowed Deal Velocity: The due diligence stage of each transaction was taking months instead of weeks, lengthening the deal timeline, introducing unnecessary risk, and reducing the USHV team’s capacity for additional acquisitions. 

Missed Tasks and Deadlines: Diligence requests were spread across multiple channels, with no clarity on who was responsible for each, causing confusion, miscommunication, and ultimately, dropped or unfinished diligence tasks. 

Duplicate Work: With no way to label or assign specific diligence requests, some were completed by multiple people, while others were sent more than once with no response. 

Overwhelmed Sellers: Physician office managers with little to no experience with the M&A diligence process were suddenly receiving multiple requests for detailed diligence information on taxes, compliance, HR, and more. 

What USHV needed was a central repository where stakeholders could view, add, and complete diligence requests and related tasks. 

“One of my first mandates when I joined USHV was organizing the diligence process, and a big part of that was figuring out how I could leverage the organization and the functionality of DealRoom to accomplish that. The number-one problem we had to solve was condensing our ask of sellers into one central location with no duplicative requests.

‍-Sam Bragg, Director of M&A, USHV

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Solution

When Sam Bragg joined the USHV team as Director of M&A, he was excited to learn that they already had DealRoom in their tech stack. He’d used the platform in past positions and found it far preferable to other software he’d come across in his career, offering an intuitive interface and helpful functionality that let him avoid “diving into thousands of Excel files.” 

As an experienced DealRoom champion, Sam immediately jumped into the platform. Using DealRoom's import feature, Sam quickly pulled all diligence requests into a single worklist. He also added custom labels to each request (tax, legal, compliance, etc.), allowing team members to filter by category. To ensure the privacy of sensitive patient and employee data, he restricted access to specific requests. At the same time, he allowed their integration team to view diligence requests as they are completed, synchronizing diligence and integration in preparation for a smoother Day 1. 

Once the basics of the diligence stream were in place, Sam communicated the shift to DealRoom to vendors and sellers alike, who quickly saw the value in the improved system and user-friendly interface. 

Why DealRoom?

Easy to navigate for even novice users, making seller and vendor adoption quick and easy.

‍Import/export, labeling, and filtering functionality made 100+ diligence requests far more manageable, measurable, and trackable. 

‍Excellent support provided rapid responses to any questions and helped the USHV team set up their initial diligence hub.

‍Single source of truth for all stakeholders, encompassing not just diligence requests but also communication, task management, and documentation across all deal stages. 

‍Templates and automation enabled USHV to establish repeatable and scalable processes for managing a large volume of diligence requests. 

‍Clear permissions settings protected sensitive patient and employee data through restricted user access. 

Outcomes

By leveraging DealRoom to unify their processes, data, and tools, as well as synchronize diligence and integration, USHV experienced several of the benefits of a Buyer-Led M&A™ approach, including: 

‍Increased Deal Capacity: USHV doubled its deals from 3 in 2022 to 6 in 2024, and is on track for 6–7 more in 2025.

‍Improved Day 1 Readiness: The integration team has access to due diligence requests as they’re completed, providing a preview of any potential issues that can be addressed before close. 

‍Formalized, Repeatable Processes: As soon as an LOI is signed, USHV has a clear process in place for setting the sellers and vendors up in DealRoom and importing any diligence requests and documentation.

‍Quicker Deal Velocity: With a central repository for all requests and the ability to filter, sort, and assign reviewers, diligence now takes days instead of months, getting the deal across the finish line faster. 

‍Streamlined Communication: In DealRoom’s interactive platform, stakeholders can tag one another, assign tasks and reviewers, drag-and-drop documents, and share timelines—all in one place. 

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