Ali Yes it all depends on what "healthcare" roll-up you are doing and where you are doing it in. Besides what everyone else already mentioned about the specific complexities within a specific area of healthhcare, there are the regulatory concerns in the US that are state specific.

Hi Ali, it really depends on the niche you’re focusing on and, crucially, the entry point for the roll-up — for example, acquiring a single established platform versus building hub-and-spoke from smaller regional operators. I’d also be very mindful of dis-synergy risk: situations where the combined group underperforms the sum of the individual businesses due to integration friction, management distraction, cultural mismatch, or incremental central overhead. In healthcare especially, those factors can erode margins faster than expected if not tightly managed from day one.