Podcast Summary: Becker Business – Strategic Insights for Healthcare and Private Equity in 2026

Host: Scott Becker
Guest: Holly Buckley, Chair of Healthcare at McGuireWoods
Date: December 5, 2025

Episode Overview

In this concise yet insightful episode, Scott Becker welcomes Holly Buckley to discuss the pressing themes shaping healthcare and private equity as they move into 2026. Focusing on margin pressures, evolving regulatory complexities, leadership strategies, and sector trends, Buckley draws from her front-line experience advising organizations navigating a turbulent healthcare landscape. The conversation zeros in on how businesses and investors can thrive amid regulatory shifts and market uncertainty, with particular attention to the emergence of AI, sustained activity in core sectors, and practical leadership tactics for sustainable growth.

Key Discussion Points and Insights

1. Defining Pressures: Margin Squeeze & Cost Challenges

[01:38–02:30]

• Holly Buckley opens with the "increased margin pressure" faced by healthcare providers, as reimbursement rates, especially from Medicaid, keep getting squeezed.
• Expense management remains crucial; while the intensity of labor cost discussions has cooled compared to previous years, these costs continue to be a factor.
• Memorable Quote:

  “Providers are really having to watch margins very, very closely. And that's always true in health care, but it feels more so the case across the board now than it has in a long time.”
  — Holly Buckley [01:45]

2. Leadership Strategies in Uncertain Times

[02:30–04:53]

• Buckley emphasizes the importance of discipline and deliberate execution over rapid, high-risk moves.

• Five years ago, broad consolidation was a workable strategy; today’s winners are those with focus, vision, and an ability to build best-in-class businesses.

• The most effective leaders are executing core strategies methodically, prioritizing incremental improvements and consistently "blocking and tackling."

• Memorable Quote:

  “It's really that people are doing things very deliberately…having real strategy and vision for what the business needs to be doing and then executing on it.”
  — Holly Buckley [03:10]

• Big risks are largely being avoided; success is coming from careful execution, not bold gambles.

• Memorable Quote:

  “Across the board I'm not seeing a lot of big risks being taken. It's more the deliberate step by step that I'm seeing prevail.”
  — Holly Buckley [04:53]

3. Regulatory and Reimbursement Landscape

[05:03–07:08]

• Regulatory scrutiny continues to intensify, especially at the state level; state laws are having outsized impacts on deal timelines—even small deals—due to low or nonexistent financial thresholds.
• Some investors are steering clear of states with especially onerous or unpredictable requirements, fearing major changes at exit.
• The newest California laws codify practice standards and expand requirements for deal disclosures, prompting more pre-deal strategizing.
• Memorable Quote:

  “We're seeing investors not go into certain states where those laws are very stringent and impose very long timelines… Something that two, three years ago was not really on most folks' radar.”
  — Holly Buckley [06:15]

4. Sectors & Technologies to Watch for 2026

[07:08–08:55]

• AI: Both in clinical delivery and back office roles, AI’s impact will keep growing, even if most current deals are small-scale. Buckley is especially enthusiastic about this evolving landscape.
• Longevity & Concierge Medicine: Paired with women's and men's health, these are burgeoning areas with significant discussion and emerging investment, although not yet massive deal volume.
• Staples Remain Strong: Home health, hospice, and dental continue to see robust activity, offering proven, lower-risk plays.
• AI in Legal Practice: Effects on day-to-day law and client experience are already being felt and will be a focus next year.
• Memorable Quote:

  “We're going to see more and more AI enabled solutions… that's going to be a super interesting area.”
  — Holly Buckley [07:25]

5. Deal Outlook for 2026

[08:55–09:54]

• The market finally picked up mid-2025 after a long lull. Now, deal pipelines are strong, with sustained inflow of new deals and processes.
• Private equity funds have dry powder to deploy, and a robust—if not "gangbusters"—year is expected in 2026.
• Memorable Quote:

  “We really did get busier… I believe the pipeline is going to be pretty strong next year. There's a huge amount of dry powder still out there.”
  — Holly Buckley [09:10]

Notable Quotes & Timestamps

• Holly Buckley on Margin Pressures:
  "Providers are really having to watch margins very, very closely... it feels more so the case across the board now than it has in a long time." – [01:45]

• On Leadership:
  "It's really that people are doing things very deliberately…having real strategy and vision for what the business needs to be doing and then executing on it." – [03:10]
  "It's more the deliberate step by step that I'm seeing prevail." – [04:53]

• On Regulation:
  "We're seeing investors not go into certain states where those laws are very stringent and impose very long timelines..." – [06:15]
  "This is just something that two, three years ago was not really on most folks' radar." – [06:58]

• On AI and Sector Hotspots:
  "We're going to see more and more AI enabled solutions… that's going to be a super interesting area." – [07:25]

• On Deal Flow:
  "I believe the pipeline is going to be pretty strong next year. There's a huge amount of dry powder still out there." – [09:10]
  "2026 is going to be... a really robust deal making year." – [09:48]

Useful Segment Timestamps

• Margin pressures and sector overview: [01:38–02:30]
• Effective leadership approaches: [03:07–04:53]
• Regulatory risks and deal impacts: [05:18–07:08]
• Emerging sector and technology trends: [07:19–08:55]
• Deal outlook for 2026: [09:01–09:54]

Episode Tone & Final Thoughts

Throughout the episode, Holly Buckley maintains a pragmatic, precise, and optimistic tone, providing clear observations for both operators and investors. Her advice is grounded—eschewing hype for measured, actionable guidance—and Scott Becker’s conversational questions create a flow that draws out candid, tactical expertise for listeners navigating the next wave of healthcare business challenges.