Healthcare Private Equity Strategy and Deal Trends with Holly Buckley of McGuireWoods LLP 2-20-26

Summary

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Becker Business Podcast: Healthcare Private Equity Strategy and Deal Trends

Guest: Holly Buckley, Chair of Healthcare Practice, McGuireWoods LLP
Host: Scott Becker
Date: February 20, 2026
Episode Theme:
A deep dive into current strategy, trends, and market dynamics in healthcare private equity, featuring insights from Holly Buckley, with a preview of the upcoming McGuireWoods Healthcare Private Equity and Finance Conference.

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Episode Overview

This episode centers on the evolving state of healthcare private equity, what strategies and sectors are proving successful in 2026, pitfalls to avoid, and how top firms differentiate themselves. Holly Buckley shares her frontline perspective, highlights trends in deals and subsectors, and discusses themes of the upcoming McGuireWoods Healthcare Private Equity Conference.

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Key Discussion Points and Insights

1. McGuireWoods Healthcare Private Equity Conference Preview

[01:14] Holly Buckley outlines the major features of the April 29-30 event in Chicago, including:

• A two-decade legacy and prominent industry participation (about 1,000 attendees).
• Michael Lewis, famed author of Moneyball, as keynote speaker.
• Dedicated tracks: provider services, pharma services, life sciences, operations, and innovation.

“We're currently putting the final touches on panels. If anyone would like a speaking slot, they're welcome to reach out…” — Holly Buckley [01:14]

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2. What’s Working in Healthcare Private Equity

[02:29] Holly Buckley emphasizes:

• Deal flow remains “really solid,” following a strong second half in 2025.
• Successful strategies now focus on deep specialization and true operational expertise, not just financial arbitrage.
• Firms with a disciplined approach to add-ons and pricing, backed by clear value creation theses, perform best.

“You can no longer just kind of go in, buy a bunch of fragmented things and rely on arbitrage and multiple expansion.” — Holly Buckley [02:29]
“It really needs to be more focused on specialization, operating expertise…the folks who really know the business and have a thesis for what they're going to do…” — Holly Buckley [02:29]

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3. What’s Not Working

[03:51] Holly Buckley details pitfalls that have become more evident:

• Platforms lacking focus, infrastructure, or a clear transformation thesis struggle.
• Overreliance on cost-cutting and synergy without integration vision is problematic.
• Disparate assets without a value-adding rationale underperform, and geographic over-concentration raises antitrust concern.

“It's more a focus on cost cutting and just kind of a straight synergy play without a real thesis around transformation…really disparate assets…not a real way to kind of bring them together…” — Holly Buckley [03:51]

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4. Hot and Cooling Subsectors in Healthcare PE

[04:50] Holly Buckley identifies high-interest areas:

• Behavioral health: Strong interest persists despite Medicaid cuts due to demand and tech opportunities.
• Physician services: Particularly where models are stable and not reliant on high-compensation physicians (e.g., dermatology, dental, value-based primary care).
• Site-of-care shifts: Investments in outpatient settings and hospital-to-home models (home health, hospice) are thriving.
• Areas seeing retrenchment include less-focused or more volatile asset plays, or those exposed to regulatory headwinds.

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5. What Sets Top Quartile Healthcare PE Firms Apart

[06:30] Holly Buckley describes “cradle-to-grave” strategy:

• Winning firms build from a strong, value-creating thesis and are disciplined throughout sourcing, ownership, and exit.
• Strong operational partnerships and in-house consulting capabilities drive execution, using talent from major consulting firms.
• Continuous preparation and narrative development for exit ensures readiness and efficiency, avoiding end-of-hold “scramble.”

“It goes through the entire life cycle of the platform from the initial thesis building all the way through exit…It's been happening all along as a matter of process.” — Holly Buckley [06:30]

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6. Conference Offerings and Networking

[08:57] Holly Buckley highlights:

• A focus on exceptional networking opportunities for deal-making.
• A more robust life sciences track, attracting deeper engagement in that sector.
• Ongoing opportunities for panel participation and engagement with leading industry figures (including host Scott Becker).

“We're really focused this year, as always, but especially this year on really great networking opportunities…” — Holly Buckley [08:57]

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Notable Quotes

• “The folks who really know the business and have a thesis for what they're going to do…seem to be doing much better…” — Holly Buckley [02:29]
• “Where there's not true infrastructure, it's more a focus on cost cutting…those platforms are the ones that have really struggled…” — Holly Buckley [03:51]
• “Behavioral health assets…still a strong interest…really strong fundamentals and…opportunity with technology and infrastructure…” — Holly Buckley [04:50]
• “A cradle to grave strategy in terms of how they grow and mature the platform…” — Holly Buckley [06:30]

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Timestamps for Key Segments

• [01:14] – Conference Preview and Features
• [02:29] – Strategies That Work in Healthcare PE
• [03:51] – What’s Not Working in Healthcare PE
• [04:50] – Attractive (and Less Attractive) Subsectors
• [06:30] – How Top Firms Differentiate
• [08:57] – Conference Networking and Expanded Life Sciences Track

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Tone and Final Impressions

The conversation is expert yet approachable, with Holly Buckley providing practical, actionable insights into the healthcare private equity landscape. Both Scott Becker and Holly maintain a collegial, forward-looking tone, focused on strategic execution, market trends, and opportunities for both learning and networking at the upcoming conference.

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For more information or to get involved with the conference, Holly Buckley welcomes direct outreach via LinkedIn or email.

Transcript

[Grainger Narrator]

This is the story of the one as the purchasing manager at a manufacturing plant, she knows the only thing more important than having the right safety gear is having it there when you need it. That's why she partners with Grainger for auto reordering, so her team members can count on her to have cut resistant gloves on hand and each shift can run safely and efficiently. Call 1-800-GRAINGER click granger.com or just stop by Grainger for the ones who get it done.

[Scott Becker]

This is Scott Becker with the Becker Business in the Becker Private Equity Podcast. We're thrilled today to be talking health care private equity with Holly Buckley. Holly heads up the healthcare practice at McGuire Woods. She also helps to cheer the McGuires Healthcare Private Equity Conference. We're going to talk today about healthcare private equity strategies areas, which is watching and a lot more. Holly, before we get started, I'm going to ask you to give us on the front end a quick Note about the McGuire Woods Healthcare Private Equity Conference in April. I'll probably ask you to wrap up with that as well and then we'll go through the substance of the conversation about what you're seeing in the healthcare private equity world currently. Holly, take it away. Tell me a little bit about the Healthcare Private Equity conference.

[Holly Buckley]

Thank you Scott and appreciate the opportunity. So McGuire is on its, I think 22nd year of its healthcare Private Equity and finance conference this year. As with the last few years, we'll be in Chicago at the Ritz on April 29th and 30th. We'll have about 1,000 folks participating, including investors, lenders and operators. This year we have Michael Lewis, the author of Moneyball, as our keynote speaker and the agenda is really shaping up to be, I think one of the best ever with tracks around provider services, pharma services and life sciences, operations and innovation. So really excited about the event. Anyone's welcome to reach out to me. We're currently putting the final touches on panels. If anyone would like a speaking slot, they're welcome to reach out either on LinkedIn or by [e-mail] Fantastic.

[Scott Becker]

Thank you so much. And let me use that to tee up what you're seeing in healthcare private equity right now and in the data deal market to start with, what's actually working healthcare private equity right now? What strategies seem to be working? Are there things that seem not to be working?

[Holly Buckley]

Yeah, yeah, happy to talk about it. And the good news is we are seeing really solid deal flow. So good news is the trend from last year of being busier the second Half of the year seems to be continuing on in 2026. I would say in terms of the things that are working, and I always say things that sound kind of too basic, but it's people who are doing things well seems to be working. So you can no longer just kind of go in, buy a bunch of fragmented things and rely on arbitrage and multiple expansion. It really needs to be more focused on specialization, operating expertise. The folks who really know the business and have a thesis for what they're going to do with the business seem to be doing much better than folks who are just trying to kind of cobble together assets. So I would say really good discipline around add ons and pricing multiples and then kind of having a real value thesis seems to be working a lot more than kind of relying on the upward trend and the rising tides floating all boats.

[Scott Becker]

Thank you. And talk about what's not working in private equity, if anything specifically you see is not working.

[Holly Buckley]

Yeah, I mean, I think it's generally kind of the lack of focus and where there's not true infrastructure, it's more a focus on cost cutting and just kind of a straight synergy play without a real thesis around transformation. And so I think those platforms are the ones that have really struggled where there is not. Maybe, you know, we're going to be very careful with things like geographic concentration because there can be antitrust concerns with that. But where there's maybe really disparate assets either geographically or focus wise and not a real way to kind of bring them together in a way that makes sense and adds value.

[Scott Becker]

And that makes sense. When you look at subsectors that are emerging as better opportunities, what do you see people looking at subsectors in other subsectors that people are quietly backing away from?

[Holly Buckley]

Yeah, I think some of the things that we're still seeing really strong interest in that are doing well. A lot of behavioral health assets. I think even with the Medicaid cuts, I think there's still a strong interest in behavioral health and outpatient mental wellness. I think there's really good demand in that sector. It's got really strong fundamentals and there's good opportunity with technology and infrastructure to be able to really add value in that space. We're also seeing strong interest in physician services where the platform is kind of very stable in terms of referral networks and the platform is not highly dependent on kind of highly compensated physicians. So more like kind of dermatology, dental value based primary care. We're still seeing good fundamentals in those sectors. And then I would say where there's a strong thesis around a movement of care to lower cost venues such as hospital to outpatient, with surgery centers, endoscopy suites, as well as hospital to home, such as home health and hospice, we're seeing really good trends there.

[Scott Becker]

Thank you very very much. And then let me ask you another question. When you see top quartile healthcare private equity firms, what separates them from other firms? What do you see that they do really well compared to others?

[Holly Buckley]

Yeah, I think it goes through the entire life cycle of the platform from the initial thesis building all the way through exit. So from the initial thesis building it's really looking at what problem are we trying to solve and what value are we looking to create for the platform and the health system kind of at the outset. And so then it's being disciplined in terms of approach, of identifying targets and winning deals on the hold period. It is the clinical and the operations credibility. And so a lot of the firms that I see doing things really well have really good operating partners. They often increasingly now have in house consulting arms where they are able to provide transformation and consulting services at a really efficient, in a really efficient manner by using in house very talented resources. And these are often incredibly talented folks who have come out of big consulting shops who are now doing this as kind of an in house consulting organization to really execute on that thesis and accelerate the the plan that was developed during the thesis building. And then it's having a constant eye towards exit throughout the whole period, making sure they are executing and then telling the story and all of their documentation and everything that they're doing and that each decision that they're making is with an eye towards the ultimate exit. And so there's not a scramble at the end in terms of how do we get this thing ready. It's been happening all along as a matter of process. And then obviously the exit itself also needs to be super disciplined and well executed. And so it's really just a cradle to grave strategy in terms of how they grow and mature the platform.

[Scott Becker]

Fantastic, fantastic. And so taking us back, I know Michael Lewis is speaking at the Healthcare Private Equity Conference. Brilliant, brilliant commentator, authority thinker. Anything else you're particularly excited about? I know I saw you winding up some other keynote chats. I know I see lots of subjects being covered. Revenue cycle, operations, technology, outpatient. Anything else top of mind that you're very excited about?

[Holly Buckley]

Yeah, I mean obviously Scott, I'm very excited to hear you speak at the conference. That's always a highlight for everyone. But I think we're really focused this year, as always, but especially this year on really great networking opportunities. And so I know a lot of the folks that come to the, to the meeting really do so so that they can meet with colleagues and network with them and hopefully work on deals. And so we're really excited for those opportunities. And I think the other thing is just really with our more robustly built out life sciences track, there's going to be great opportunities, as always on the provider services side. But really for those also wanting to take a deeper dive on life sciences, we're going to have much more robust content and attendees this year in that space. So really just the whole thing is going to be fantastic. But happy, happy for anyone to reach out with questions and to chat about what their role could be.

[Scott Becker]

Holly Holly buckley, chair of McGuire Woods Healthcare, chair of also the McGuire Woods Healthcare Private Equity Conference. Thank you so much for joining us today on the Becker Private Equity and the Becker Business Podcast. Just fantastic. Thank you so much. Thank you. Thank you.

[Holly Buckley]

Thank you. Scott.

[Grainger Narrator]

This is the story of the one as the purchasing manager at a manufacturing plant, she knows the only thing more important than having the right safety gear is having it there when you need it. That's why she partners with Grainger for auto reordering, so her team members can count on her to have cut resistant gloves on hand and each shift can run safely and and efficiently. Call 1-800-granger. Click granger.com or just stop by Granger for the ones who get it done.