A $5M price reduction at signing became $16M of value creation in year one
Situation
A mid-market fund was evaluating a patient engagement platform as the anchor for a buy-and-build strategy. Reported cloud spend was $4.5M — 10% of revenue, high for healthcare SaaS but not disqualifying. The stack looked modern and SOC 2 and HIPAA compliance were both claimed. Nothing in initial screening justified walking away, and the deal proceeded to LOI at 11x EBITDA.
Approach
Six weeks of technical diligence found actual spend was $5.2M — management had excluded several accounts — putting it at 11.5% of revenue. Development environments ran at production scale around the clock ($800K), databases were provisioned at 4x observed utilization ($600K), and no cost allocation or tagging existed anywhere. Total identified optimization was $1.8M, about 35% of spend. HIPAA implementation had real gaps: incomplete encryption at rest, audit logging holes, undocumented access reviews. Scored against the Technology Risk Assessment framework, the findings totaled 10 points and supported a −0.5x multiple adjustment.
Outcome
The firm repriced from 11x to 10.5x — a $5M reduction — and negotiated a $3M escrow covering security remediation. The 100-day plan targeted $1.5M of first-year optimization. Shutting down development environments outside business hours captured $400K in the first 30 days; right-sizing the worst-provisioned databases added $300K. By month twelve, spend had fallen from $5.2M to $3.6M while revenue grew 38%, and cloud dropped from 11.5% of revenue to 5.8% — below the industry benchmark. The $1.6M of EBITDA improvement translated to roughly $16M of enterprise value at the company's exit multiple.