Becker Business Podcast Summary

Episode: Regulatory Shifts, Deal Market Trends, and Strategic Focus in Healthcare with Holly Buckley of McGuireWoods LLP
Host: Scott Becker
Guest: Holly Buckley, Chair of the Healthcare Department at McGuireWoods LLP
Release Date: August 5, 2025

Introduction

In this insightful episode of the Becker Business Podcast, host Scott Becker engages in a comprehensive discussion with Holly Buckley, the Chair of the Healthcare Department at McGuireWoods LLP. Holly, who operates at the nexus of healthcare, private equity, and business, delves into critical topics affecting the healthcare sector. The conversation centers around recent regulatory updates, trends in the private equity deal market, and strategic priorities for the remainder of the year.

1. Regulatory Updates Impacting Healthcare and Private Equity

July Legislation and Its Implications

Holly Buckley begins by addressing a significant legislative development signed into law in July. She outlines the Congressional Budget Office (CBO) score, highlighting a projected $3.4 trillion increase in the national deficit and an alarming forecast that 10 million Americans may lose their health insurance coverage (00:46). The legislation introduces sweeping changes, including:

• Tax Reforms and Medicaid Cuts: These modifications are poised to reshape the financial landscape for healthcare providers and insurers.

• Medicare Physician Payments: A notable 2.5% increase in Medicare physician payments is slated for 2026, indicating a shift towards supporting healthcare providers financially (00:46).

• Rural Hospital Fund: Contrary to its name, this $50 billion fund is designed to support a broad range of rural health initiatives beyond hospitals, such as clinics and telehealth providers. This initiative is expected to stimulate advancements in rural healthcare delivery (00:46).

CMS Policy Shifts

Buckley elaborates on changes within the Centers for Medicare & Medicaid Services (CMS), emphasizing a strategic move to transition care to less costly settings. Key policy updates include:

• Site-Neutral Payment Policies: CMS is eliminating the inpatient-only list for surgeries and expanding the range of outpatient procedures reimbursable through Ambulatory Surgical Centers (ASCs) (00:46).

• Reimbursement Adjustments: A proposed rule aims to reduce reimbursement rates for skin substitutes, posing significant challenges for wound care providers.

• Home Health and Durable Medical Equipment (DME): New rules address payment updates, quality reporting, and changes to face-to-face encounter policies, indicating a comprehensive overhaul of outpatient care reimbursement (00:46).

Heightened Enforcement Focus

The discussion shifts to the government's re-emphasized enforcement priorities, particularly concerning the False Claims Act (FCA). Buckley notes that the Department of Justice (DOJ) and the Department of Health and Human Services (HHS) have reinvigorated their FCA Working Group, signaling a renewed commitment to healthcare fraud prevention. Areas of focus include:

• Medicare Advantage and Managed Care Fraud: Increased scrutiny on fraud within managed care environments.

• Kickbacks and Pricing Practices: Ongoing investigations into illicit kickbacks and the pricing strategies of drugs and biologics (00:46).

Buckley anticipates that these enforcement efforts will continue the aggressive FCA enforcement seen during the Trump administration, with a particular focus on remote patient monitoring (00:46).

Notable Quote:

"The DOJ and HHS has relaunched their False Claims Act Working Group which signals a renewed focus on health care enforcement." – Holly Buckley (00:46)

2. Industry Perspectives on the "One Big Beautiful Bill"

Contrasting Views Between Legislation and Industry Sentiment

Scott Becker probes further into the apparent discrepancy between the legislative optimism surrounding the bill and the overwhelming negativity expressed by various industry stakeholders, including physicians, ambulatory surgical centers (ASCs), and health systems.

Buckley acknowledges the widespread trepidation among hospitals and health systems due to Medicaid cuts. She explains that the loss of health insurance for 10 million Americans will likely burden hospitals and health systems with increased patient volumes, particularly in emergency rooms. This surge could strain resources and escalate operational costs, potentially diminishing the anticipated benefits of the Rural Hospital Fund (03:57).

Private Equity’s Mixed Reactions

While the provider community expresses significant concern, the private equity sector exhibits a mixed response. Buckley notes that:

• Negative Impacts: Certain healthcare sectors may suffer financially due to reduced Medicaid funding and increased patient loads.

• Opportunities for Investment: Conversely, some private equity investors are identifying opportunities to develop systems that support state requirements and enhance post-COVID healthcare delivery. For instance, investors are exploring ventures that align with new regulatory mandates and the shifting healthcare landscape (03:57).

Notable Quote:

"There’s definitely some who see opportunity, but I think amongst the provider community, I think it is viewed very negatively." – Holly Buckley (03:57)

3. Current Trends in the Private Equity Deal Market

A Busy Second Half of the Year

Transitioning to deal market trends, Buckley reports a robust second half of the year. She observes increased activity in both the buy-side and sell-side transactions, indicating a healthy and dynamic market environment.

• Platform Buy-Side Deals: There is a notable uptick in platform acquisitions, suggesting that private equity firms are actively consolidating and expanding their portfolios.

• Sell-Side Robustness: Sellers remain confident, contributing to sustained transactional volume and market stability (05:31).

Buckley anticipates that the back half of 2025 will continue this strong momentum, with sustained activity and favorable market conditions.

Notable Quote:

"We're seeing some really nice platform buy side deals. We're seeing the platform deal market also picking up and sell sides continuing to remain relatively robust for the year." – Holly Buckley (05:31)

4. Strategic Focus and Priorities for the Remainder of the Year

Expansion of FDA and Life Sciences Group

Highlighting the strategic initiatives of her team, Buckley emphasizes the ongoing growth of the FDA and life sciences group within McGuireWoods. Over the past 18 months, this group has experienced significant development, and the focus remains on:

• Market Expansion: Enhancing the group's presence in the life sciences sector and supporting both service providers and financial investors.

• Client Support: Assisting investors and lenders in navigating the complex regulatory and operational landscapes of life sciences (06:17).

Talent Development and Execution Excellence

Beyond sector-specific growth, Buckley underscores the importance of executing client engagements effectively and developing a strong talent pool. As client activity increases in the latter part of the year, ensuring top-tier service and expanding team capabilities are paramount (06:17).

Notable Quote:

"We continue to look at building out and growing our FDA and life sciences group... and that's just been a very, a very fun area and one that we'll continue to focus in." – Holly Buckley (06:17)

Conclusion

Scott Becker wraps up the episode by acknowledging Holly Buckley's comprehensive insights into the evolving healthcare regulatory landscape, the vibrant private equity deal market, and the strategic priorities guiding her team. Buckley's expertise offers valuable perspectives for stakeholders navigating the intersections of healthcare, law, and private equity.

Notable Closing Quote:

"Thank you for sharing with us the regulatory updates, the deal outlook as well as the focus for the rest of the year..." – Scott Becker (07:09)

Key Takeaways

• Legislative Impacts: The July bill introduces significant changes, including Medicaid cuts and Medicare payment increases, which will have profound effects on healthcare providers and the private equity landscape.

• Industry Sentiment: While legislators may view the bill favorably, healthcare providers express significant concerns about the financial and operational strains resulting from reduced Medicaid funding and increased uninsured populations.

• Deal Market Dynamics: The private equity deal market remains active and robust, with strong buy-side and sell-side activities anticipated to continue through the end of 2025.

• Strategic Growth Areas: Expanding expertise in FDA and life sciences, coupled with a focus on talent development and client execution, are key strategic priorities for McGuireWoods LLP's healthcare department.

Timestamp Reference Guide:

• 00:46: Holly Buckley's overview of regulatory updates.
• 03:57: Discussion on industry perspectives and private equity reactions.
• 05:31: Insights into the private equity deal market trends.
• 06:17: Strategic focus and priorities for the remainder of the year.
• 07:09: Closing remarks by Scott Becker.

This episode provides a thorough examination of the current state and future directions of healthcare regulation, private equity involvement, and strategic operational focuses within the sector. Whether you're a healthcare provider, private equity investor, or industry observer, Holly Buckley's expert analysis offers valuable guidance in navigating these complex dynamics.