2025 - A Texas-based ENT group, owning a $4MM practice facility, planned to bring two new physicians into the real estate ownership. With a lowly leveraged loan amount relative to the property value, the high buy-in costs posed a challenge for incoming partners, leading the group to engage CMAC Partners. CMAC utilized its proprietary 30-year model, analyzing various strategies to address these buy-in challenges. The model demonstrated how each option would affect affordability for the new partners, as well as the resulting impact on returns for both incoming and existing partners. Ultimately, the group determined that a cash-out refinance strategy was the most effective path forward and engaged CMAC to comprehensively vet the market for the most competitive financing options. This process yielded proposals that were up to 1.10% less than the incumbent lender's pricing. The resulting cash-out refinance enabled new partners to buy in at a reduced cost and higher return, while ensuring that existing partners were fairly compensated for the equity that they had built in the investment.