About 10x EBITDA is the GCC healthcare platform benchmark, and scale plus margin quality is what earns it

CHG grew FY2025 revenue about 11% to roughly AED 404 million and EBITDA about 14% to around AED 100 million. Notice which line grew faster. Amanat did not pay 10x turnover; it paid roughly 10x earnings, and earnings grew ahead of the top line because the platform was converting scale into margin. An owner who fixates on revenue is measuring the wrong thing. A group doing AED 400 million of revenue at a 25% EBITDA margin is worth materially more than one doing AED 500 million at 12%, and no buyer will apologise for saying so. The quality of each dirham of earnings is what gets capitalised.

CHG runs about 715 beds across six facilities in the UAE and Saudi Arabia with more than 1,200 staff. That footprint spreads corporate overhead, procurement and clinical governance across a base large enough to absorb the cost of running them properly. It gives payors a network worth contracting with. It means no single asset, regulator or medical director can sink the business. A buyer underwrites all of that as lower risk, and lower risk is precisely what a double-digit multiple encodes. The platform is not valued highly because it is big. It is valued highly because being big made its cash flows harder to disrupt.

Take one hospital doing AED 15 million of EBITDA. Its margin might match CHG's, but its earnings hang on one catchment, one licence, one anchor consultant and one payor relationship. Concentrate risk that way and a buyer discounts it, often to five or six times, sometimes less. The platform multiple is a reward for diversification the single asset structurally cannot offer. This is also why a group is worth more than the sum of the clinics inside it: assembling them removed the very risks that would have capped each one on its own. The re-rating from single-asset money to platform money is the prize, and it is only available to owners who built genuine scale before they sold.

Full ownership arrived in stages, the last of them the 10.03% at AED 105 million. Each tranche was a fresh valuation event, and by the final one both sides had years of shared operating data to price against. That is the opposite of a one-shot negotiation where a number is argued from a model and a hope. It is also a reminder that the multiple you eventually achieve is downstream of how legible your numbers are. If your EBITDA cannot survive a quality-of-earnings review, if add-backs are soft, if margins depend on a related-party arrangement, the 10x benchmark is not yours. It belongs to groups whose earnings hold up when a buyer's advisers pull them apart.

For a profitable, multi-site GCC healthcare platform with clean, growing earnings and real diversification, it is a fair anchor. For a sub-scale asset, or a group whose reported EBITDA does not stand up to scrutiny, it is aspirational. The gap between the two is where most of the value in a healthcare exit is won or lost, and closing it is usually work you do in the two years before you ever run a process.

A benchmark is only useful if you can act on it, and for a family or founder-led group the way to act is often not one signing and a clean break but a staged sell-down: sell control or a large minority now, the balance over time. Amanat did not take Cambridge Health Group in a single move. It reached 100% through successive buy-ins, the last of them 10.03% for about AED 105 million. Full ownership was the destination, not the opening bid. The first tranche crystallises value immediately and de-risks the family balance sheet, while later tranches price against results the business actually delivers, so if the group performs the owner captures that growth rather than handing it to the buyer for nothing. It also matches what the buyer needs. A purchaser taking control of a founder-run hospital group is underwriting whether culture, referral relationships and clinical leadership survive the handover, and a retained seller stake is their insurance that they will. That shared exposure often supports a fuller price than a buyer would pay someone walking out on day one.

The moment you sell control you are a minority in a business you used to own outright. Board seats, reserved matters, drag and tag rights, dividend policy and the mechanism for valuing the later tranches stop being formalities and become the whole of what your remaining stake is worth. Get the shareholders' agreement wrong and you are a passenger, your upside diluted by decisions you cannot influence and your exit timed by someone else. All of it is settled at the first signing, not the last, and it is where owners with strong operating instincts and thin deal experience give ground they never recover. The pricing mechanism deserves the same scrutiny. A fixed multiple agreed today shelters you from a soft market but caps the re-rating you are working toward. A formula tied to future EBITDA rewards performance while exposing you to how EBITDA is measured, and by whom. A fresh negotiation each time leaves the number to whoever holds leverage on the day. Model the outcomes before you agree to the mechanism, not after.