CohnReznick Bolsters Healthcare Due Diligence for ABA Transactions

The Firm

NEW YORK, NEW YORK, CohnReznick LLP is one of the top 15 CPA firms in the United States by revenue, with annual revenue of approximately $1 billion and more than 5,000 professionals across 29 office locations in major U.S. business centers. The firm was formed in 2012 through the merger of J.H. Cohn, founded in 1919, and the Reznick Group, founded in 1977. CohnReznick is led by CEO David Kessler and is a member of Nexia International, expanding its global reach to more than 120 countries. The firm was named to INSIDE Public Accounting’s Best of the Best CPA Firms list for 2025 and was certified as a Great Place to Work in 2024.

CohnReznick provides advisory, assurance, and tax services across industries including healthcare, real estate, financial services, renewable energy, technology, and private equity. The firm’s healthcare practice provides strategic advisory, audit, and tax solutions designed to help healthcare organizations improve operations and enhance patient care. The firm’s private equity practice serves the entire investment management ecosystem, from PE firms and their portfolio companies to hedge funds and independent sponsors, with transaction advisory, compliance, and fund administration services.

The firm’s Value360 Practice, led by Managing Principal Claudine Cohen, integrates transaction advisory services with strategic consulting and operational assessment to provide PE clients with a comprehensive view of deal value. Cohen previously led the transaction advisory services healthcare industry group at a national accounting firm, bringing deep sector-specific experience in hospitals, physician practices, ambulatory clinics, healthcare service businesses, medical devices, and laboratories. Her leadership of the Value360 Practice signals CohnReznick’s commitment to healthcare transaction advisory as a strategic growth area.

Transaction Advisory Practice

CohnReznick’s Transaction Advisory Practice provides detailed quality of earnings, net working capital, and debt and debt-like analyses, accompanied by a critical P&L analysis of revenue, expenses, contribution, and EBITDA margins as well as significant balance sheet accounts. The firm describes its approach as placing industry-specific quality of earnings at the core, with customized analysis reflecting the unique characteristics of each transaction.

The firm’s transaction advisory services span the full deal lifecycle: pre-transaction readiness assessment, buy-side due diligence, sell-side due diligence, financial modeling and benchmarking, and post-close dispute resolution. CohnReznick’s expanded Sale and Purchase Agreement Advisory practice, led by Laura Kobes, helps clients navigate the complexities of M&A transactions and resolve post-close disputes related to working capital adjustments, earnout calculations, indemnification claims, and breach of warranty claims.

CohnReznick describes itself as a go-to due diligence provider to PE funds focused on U.S. middle-market companies, with industry-specific quality of earnings at the core and partner-led teams of seasoned M&A professionals delivering customized analysis for every transaction.

Healthcare Due Diligence Capabilities

CohnReznick is actively recruiting healthcare-specific transaction advisory professionals. The firm has posted TAS Manager positions specifically requiring healthcare experience, including knowledge of providers, reimbursement risks, and revenue cycles, in offices including New York, Chicago, Los Angeles, and Boston. The job requirements specify five or more years of audit or transaction advisory experience within the healthcare industry, a hiring profile that signals the firm is building dedicated healthcare diligence capacity rather than treating healthcare as a generalist engagement.

The firm’s healthcare transaction advisory work includes evaluating revenue sources and profitability drivers, examining operating cost structures and sustainability factors, investigating business models including cash flow and financial projections, reviewing quality and realization of assets and liabilities, and identifying working capital requirements and negotiating positions. These are the core QofE dimensions that PE sponsors require when evaluating ABA platform acquisitions.

CohnReznick’s 2025 Transaction Advisory Highlights document reports the firm’s involvement in healthcare transactions including sell-side due diligence services for the acquisition of the Neuroscience Education Institute by HMP Global. The firm actively participates in healthcare PE deal conferences, including the ACG NY Annual Healthcare Conference and the McGuireWoods Annual Healthcare PE & Finance Conference, venues where healthcare-focused PE sponsors and their advisors meet to discuss deal pipeline and market dynamics.

Claudine Cohen’s background as a former healthcare TAS industry group leader at a national firm provides CohnReznick with depth of experience in healthcare subsectors including physician practices, ambulatory clinics, and healthcare service businesses. Her areas of knowledge span strategic advisory, quality of earnings analysis, revenue source identification, profitability driver examination, operating cost structure assessment, business model investigation, working capital analysis, and post-close working capital verification, the complete toolkit required for ABA platform due diligence.

Where CohnReznick Fits in ABA M&A

CohnReznick competes in the middle-market healthcare due diligence space alongside RSM, BDO, Grant Thornton, and Baker Tilly. The firm’s differentiators include the Value360 Practice’s integrated approach to transaction advisory, the healthcare-experienced leadership of Claudine Cohen, and the firm’s active investment in building dedicated healthcare TAS capacity through targeted hiring.

The firm’s positioning as a go-to PE due diligence provider is particularly relevant to ABA M&A, where private equity sponsors drive the majority of transaction activity. CohnReznick’s established relationships with PE funds, through its fund administration, compliance, and portfolio company advisory services, create a natural pathway to due diligence engagements when those sponsors evaluate ABA acquisition targets. This relationship-based engagement model means CohnReznick often has existing familiarity with a PE sponsor’s investment criteria, return expectations, and diligence preferences before a specific ABA deal materializes.

The firm’s SPA Advisory practice adds a post-transaction dimension that is increasingly relevant in ABA M&A. As ABA transactions grow more complex, with earnout provisions tied to clinical performance metrics, working capital adjustments affected by Medicaid claims processing cycles, and indemnification claims related to regulatory compliance, the ability to resolve post-close disputes efficiently becomes a competitive advantage for the advisory firm that conducted the initial diligence.

CohnReznick’s active hiring of healthcare-specific TAS professionals in multiple offices signals that the firm views ABA and behavioral health due diligence as a strategic growth area, a leading indicator of sustained institutional demand for ABA transaction advisory services.

The firm’s performance improvement and restructuring practices provide capabilities that extend CohnReznick’s engagement beyond initial due diligence into post-acquisition value creation and, when necessary, operational turnaround. For ABA platforms that are underperforming relative to the buyer’s expectations, due to reimbursement rate compression, workforce challenges, or integration difficulties, CohnReznick’s performance improvement team provides the operational advisory to stabilize and improve financial performance during the hold period.

CohnReznick’s technology and media practice, led in part by Greg Mochizuki from the firm’s San Francisco office, serves upper middle-market PE firms and acquisitive companies in the technology sector. While distinct from healthcare, this technology advisory capability is relevant to ABA transactions where practice management platforms, telehealth technology, AI-driven clinical decision support tools, and data analytics are increasingly central to the target’s operational model and growth thesis.

The firm’s membership in Nexia International provides global reach across more than 120 countries. While ABA due diligence is primarily a domestic engagement, the Nexia network enables CohnReznick to support PE sponsors with international portfolio companies or to provide advisory services for behavioral health organizations exploring international expansion. The network also provides access to international regulatory and tax expertise that may be relevant to specific transaction structures.

CohnReznick’s post-close advisory capabilities include working capital verification, earnout measurement, and dispute resolution. In ABA transactions where purchase price structures often include earnout provisions tied to future EBITDA performance or clinical growth milestones, the accuracy and defensibility of post-close calculations directly affect the economic outcome for both buyer and seller. CohnReznick’s SPA Advisory practice, led by Laura Kobes and expanded with the addition of Andrew Still, provides the specialized expertise to navigate these post-close financial determinations.

The firm’s healthcare practice extends beyond transaction advisory to include strategic advisory, audit, and tax services designed to help healthcare organizations improve operations and enhance patient care. This breadth of healthcare services creates institutional knowledge that informs the firm’s due diligence work. When CohnReznick’s TAS team evaluates an ABA target’s financial performance, it does so with the benefit of insights from colleagues who advise healthcare organizations on operational improvement, regulatory compliance, and tax optimization, context that enriches the financial analysis.

CohnReznick’s transaction advisory capabilities also include financial modeling and benchmarking services that provide deal teams with scenario analysis for investment evaluation. Using historical financial statements and industry-specific databases, the firm evaluates a company’s financial and operating performance against best-in-class peers. For ABA transactions, this benchmarking capability helps PE buyers understand how a target’s key performance indicators, clinician utilization rates, revenue per billable hour, authorization conversion rates, payer mix distribution, compare to industry norms and to the sponsor’s existing portfolio companies.

Key Considerations for ABA Stakeholders

For ABA practice owners, CohnReznick’s healthcare TAS team represents a partner-led, mid-market diligence provider with growing healthcare specialization. The firm’s emphasis on customized QofE analysis means that owners can expect diligence tailored to the specific revenue, cost, and working capital dynamics of their ABA practice rather than a template-driven approach.

For PE sponsors, CohnReznick’s integration of fund-level services with portfolio company transaction advisory creates a seamless advisory relationship from fund formation through deal execution. The firm’s Value360 Practice provides strategic context alongside financial diligence, helping sponsors evaluate not just whether historical earnings are sustainable but whether the target’s business model and market position support the growth assumptions embedded in the investment thesis.

For the ABA industry, CohnReznick’s healthcare TAS hiring activity, particularly in major PE markets like New York, Chicago, and Los Angeles, signals that middle-market advisory firms are building dedicated capacity for behavioral health due diligence. This investment in specialized talent reflects the growing volume and complexity of ABA transactions and suggests that the demand for sector-specific diligence expertise will continue to increase.

The firm also provides HR due diligence that reviews health and welfare programs, compensation and benefits structures, retirement plans, labor contracts, and strategic cultural fit. In ABA transactions where clinical workforce dynamics directly affect both current earnings and post-acquisition growth capacity, this HR diligence dimension provides PE buyers with insight into retention risk, compensation competitiveness, and organizational culture alignment that financial-only diligence cannot capture. CohnReznick’s IT due diligence assesses data and security risks while identifying opportunities to drive efficiencies through technology, relevant to ABA platforms where EHR system quality, billing platform reliability, and data security practices affect both operational performance and regulatory compliance.

CohnReznick’s approach to due diligence integrates a critical examination of revenue drivers and margin dynamics through analyses that may include price-volume-mix decomposition, customer churn assessment, revenue-margin analysis, revenue waterfall charting, and lookback analysis. For ABA transactions, these analytical tools enable the firm to evaluate whether revenue growth is driven by patient census increases, rate improvements, utilization changes, or payer mix shifts, and whether the earnings trajectory is sustainable given the specific dynamics of each revenue component.

CohnReznick’s century-plus heritage, rooted in J.H. Cohn’s 1919 founding, provides the institutional stability and market credibility that PE sponsors and their portfolio companies value in an advisory relationship. The firm’s consistent growth, strategic hiring in healthcare TAS, and active participation in the PE conference circuit all signal a firm that is building deliberately toward a leadership position in middle-market healthcare due diligence. For the ABA sector specifically, CohnReznick’s combination of established PE relationships, healthcare industry expertise, and customized QofE methodology creates a compelling advisory platform.

In February 2025, CohnReznick announced a significant growth investment from Apax Funds, making it the latest major accounting firm to receive private equity backing. The Apax investment will support CohnReznick in expanding service lines, developing technology solutions, entering new markets, and pursuing targeted acquisitions. Following the transaction, CohnReznick operates in an alternative practice structure with CohnReznick LLP providing attest services and CohnReznick Advisory LLC providing tax, advisory, and other non-attest services. This PE-backed structure aligns CohnReznick with its middle-market competitors and provides the capital to accelerate growth in high-demand sectors including healthcare transaction advisory.

CohnReznick’s Value360 Practice represents a differentiated approach to transaction advisory that extends beyond traditional quality of earnings analysis. By integrating financial due diligence with strategic consulting and operational assessment, the Value360 framework provides PE sponsors with a more comprehensive view of acquisition targets. For ABA transactions where earnings sustainability depends on clinical operational factors, payer contracting strategies, and regulatory compliance that traditional financial QofE may not fully capture, this integrated approach can surface material findings that inform investment committee decisions.

The firm’s active recruitment of healthcare-specific TAS professionals in major PE markets reflects a deliberate capacity-building strategy. Healthcare due diligence requires professionals who understand reimbursement dynamics, regulatory compliance requirements, clinical operational metrics, and the revenue recognition complexities specific to healthcare service businesses. By hiring professionals with this specific expertise, CohnReznick is positioning itself to handle the growing volume of behavioral health and ABA due diligence engagements that PE sponsors are bringing to market.

CohnReznick’s SPA Advisory practice addresses an increasingly important dimension of ABA transactions. As deal structures become more complex, with earnout provisions tied to clinical outcomes, working capital adjustments based on claims receivable definitions, and indemnification provisions for regulatory compliance representations, post-close dispute resolution capabilities become a critical differentiator. The firm’s ability to advise on purchase price mechanisms at the diligence stage and then support dispute resolution after closing provides continuity that benefits both buyers and sellers throughout the transaction lifecycle.

The firm’s century-plus heritage, rooted in J.H. Cohn’s 1919 founding, provides institutional stability and market credibility that PE sponsors value when selecting advisory partners. CohnReznick’s consistent focus on the middle market, combined with its new PE-backed growth trajectory under Apax, positions the firm to expand its healthcare transaction advisory capabilities at a time when ABA deal volume continues to accelerate.

AT A GLANCE

SOURCES & REFERENCES