Healthcare Deals, Digital Growth, and Market Headwinds with Holly Buckley of McGuireWoods LLP 6-10-25

Summary

Becker Private Equity & Business Podcast: Detailed Summary

Episode Title: Healthcare Deals, Digital Growth, and Market Headwinds with Holly Buckley of McGuireWoods LLP
Release Date: June 10, 2025
Host: Scott Becker
Guest: Holly Buckley, Chair of Healthcare at McGuireWoods LLP

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Introduction to Holly Buckley

In this highly anticipated episode of the Becker Private Equity and Business Podcast, host Scott Becker welcomes Holly Buckley, a prominent figure and one of the most listened-to guests in the podcast's history. Holly Buckley, serving as the Chair of Healthcare at McGuireWoods LLP, brings invaluable insights from the intersection of healthcare and private equity, shedding light on current market trends, investment opportunities, and future projections.

Current State of the Business Deal Market

Scott initiates the conversation by inquiring about the present dynamics within the business deal market. Holly provides a nuanced perspective, describing the market as "tepid, hopefully heading in the right direction" (00:50). She observes fluctuations in deal activity:

• Increased Activity Days: Holly notes that on certain days, deal-making seems to "heat up a little," indicating sporadic surges in transactions.

• Stagnant Activity Days: Conversely, there are days when deals "are still buying and not moving forward," highlighting underlying uncertainties.

Despite the mixed signals, Holly points out positive trends such as successful exits and the initiation of new deals, particularly in adjacent sectors to direct provider services.

Activity in Adjacent Spaces vs. Direct Provider Services

Scott delves deeper into the distinction between direct provider services and adjacent sectors. He remarks on the current challenges faced by direct provider investments, including "middle margins, some margin pressures, and high interest costs that are making some of those what were traditionally physician practice management deals more challenging" (02:00).

Holly concurs, emphasizing the resilience of multi-facility businesses and the robust activity in adjacent areas like the veterinary sector. She elaborates that while direct provider services are experiencing a slowdown, adjacent sectors—especially those supporting healthcare delivery—are witnessing increased investment:

• Healthcare IT and Digital Health: These areas are gaining traction as businesses mature and become viable for private equity investments.

• Cash-Only Businesses: Sectors like veterinary services and med spas, which operate on cash transactions without relying on payer reimbursements, are thriving.

Investment Focus Areas: Healthcare IT and Digital Health

When asked about the most exciting segments within adjacent spaces, Holly highlights Healthcare IT and Digital Health as prime areas of interest. She articulates the enthusiasm surrounding investments aimed at "trying to make healthcare better" by fundamentally changing how services are delivered.

Notable Insights:

• Technological Solutions: There is a significant push towards investing in "IT type solutions" that enhance healthcare delivery.

• Problem-Solving with Technology: Holly emphasizes the role of technology in addressing challenges like Medicaid efficiency and workforce management. She states, “how can we do Medicaid better, how can we better facilitate back to work requirements” (03:39).

• Workforce Optimization: Technology is being leveraged to manage the workforce more effectively, allowing professionals to focus on their core competencies by automating non-essential tasks.

Projections for the Rest of the Year

Turning to future outlooks, Scott probes Holly for her predictions amid current economic uncertainties. Holly provides a cautious yet insightful forecast:

• Economic Uncertainty: She anticipates that the remainder of the year will be heavily influenced by factors such as the "one big beautiful bill" and ongoing tariff policies (04:55).

• Potential Recession: There is a possibility of entering a recession in the second half of the year, driven by "tariffs" and their economic impact.

• Stock Market Caution: Despite the stock market reaching all-time highs, Holly advises caution, suggesting that current valuations "may be too good to be true."

• Legislative Impact: The outcome of legislative actions, particularly the passage or stalling of the mentioned bill, will significantly determine economic and market trajectories.

Holly concludes that businesses require more certainty to navigate the unpredictable environment, as the "constant whipsawing" could exacerbate current challenges, potentially leading to a "much worse spot" than presently experienced.

Conclusion

Scott Becker wraps up the insightful discussion by commending Holly for her balanced and hedged approach to market analysis. He characterizes her perspective as "the most rational approach," underscoring the value of her expertise and leadership in the healthcare and private equity sectors. Holly reciprocates the appreciation, concluding the episode on a note of mutual respect and anticipation for future dialogues.

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Notable Quotes:

• "The market as tepid, hopefully heading in the right direction." — Holly Buckley (00:50)

• "Adjacents spaces, that are provider light, but really things that sell into providers, technology, software, digital, all kinds of other things versus direct provider spaces." — Scott Becker (02:32)

• "Investment in trying to make healthcare better, which is something I think for most of us that work in healthcare in any way is exciting." — Holly Buckley (03:39)

• "We need to see what happens with a one big beautiful bill. Are we going to be headed for a government shutdown or is the bill largely going to be passed?" — Holly Buckley (04:55)

Timestamps

• Introduction: 00:15
• Current Market State: 00:50
• Direct vs. Adjacent Services: 02:32
• Investment Focus Areas: 03:39
• Future Projections: 04:55
• Conclusion: 06:41

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This summary encapsulates the key discussions and insights shared by Scott Becker and Holly Buckley during their conversation on the Becker Private Equity and Business Podcast. For a comprehensive understanding, listeners are encouraged to tune into the full episode.

Transcript

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[Scott Becker]

This is Scott Becker with the Becker Private Equity and Business Podcast. We're visiting today with one of our most listened to guests in the history of the podcast. The podcast just passed 7 million downloads, been really highly ranked and no one is more central to that than Holly Buckley, the chair of health care at McGuire woods and somebody who works brilliantly in the middle of health care and private equity. Just a brilliant leader. Holly, tell us what you're seeing today in the business deal market. What are you seeing currently? Is it moving in the right direction? The wrong direction? What are you seeing currently?

[Holly Buckley]

You know, it's a great question and I think there isn't a great answer. I think some days I think we seem to be heating up a little, There seems to be more activity. I think other days it seems like there's still a lot of deals buying and not moving forward. I think overall I would describe the market as tepid, hopefully heading in the right direction. We've been saying that for a while. We are seeing some good exits happen, which is really reassuring that some are good buyers out there. We're seeing some increase on add on activity and we are seeing some new deals get started. I think a fair amount of the new deals are in kind of adjacent spaces to direct provider services. There are some direct provider services deals happening, but that section of the market is slower I think than some of the adjacent areas.

[Scott Becker]

No, thank you so much. It seems like the bloom is a little bit off the rose in investing in direct providers as you still have sort of middle margins, some margin pressures and high interest costs that are making some of those what were traditionally physician practice management deals more challenging. Multi facility deals I think still going well and things obviously in adjacent space like the vet space going well but. But you're absolutely, I think spot on that so much of the deal activities, what we used to call provider light, but really things that sell into providers, technology, software, digital, all kinds of other things versus direct provider spaces. Is that a fair statement, a fair assessment of what you're saying?

[Holly Buckley]

It is. And I think when we talk about adjacent spaces, I think the thing I hear the most about this year is IT type solutions. So technological solutions that support delivering health care better. And I think for a long time a lot of these businesses were too small, were revenue negative and we're finally seeing Some nice businesses grow up and become viable for private equity out of the venture space. And so we are seeing more transactions in the digital health healthcare IT world which is exciting and fun. In addition to some of the kind of provider spaces like Vet and med spa, maybe cash only businesses that aren't getting payer reimbursement or federal health care program reimbursement. So a whole bunch of things happening, just more slowness in the direct provider services. But I hear you on the multi facility businesses, they seem to be doing okay as well.

[Scott Becker]

Thank you very very much. Second, in terms of sort of these adjacent spaces, where are you finding the most interest, the most excitement part of.

[Holly Buckley]

The healthcare IT and digital health? It's kind of the investment in trying to make healthcare better, which is something I think for most of us that work in healthcare in any way is exciting. But seeing kind of investment and growth by companies who are trying to change how healthcare is fundamentally delivered. So even with the headwinds in the Medicaid space with the one big beautiful bill, we're seeing a fair amount of excitement from investors and entrepreneurs in terms of well, how can we do Medicaid better, how can we better facilitate back to work requirements and things like that. And so the idea of using technology to solve problems and staffing is another great example in terms of managing the workforce as well as letting people operate at the top of their license by taking non essential functions off people's plate and putting them on technology's plate. That's where I think we're seeing the most activity and to me it's the most exciting.

[Scott Becker]

Thank you very very much. And Howie, any projections on the rest of the year? I mean it seems like with all the turmoil out there, people talking about so many different issues, you have the stock marketing all times highs and people started to get deal hungry again and deal engaged again. What's your sense of what the next six months looks like?

[Holly Buckley]

Oh, I may be done making predictions, but let me try. So I think that some of it's going to depend on what happens with the, with the one big beautiful bill. I think another big factor is going to be tariffs. I think we're hearing from some economists that we're likely to have a recession in the second half, enter into a recession in the second half of the year. I certainly think that that is very much possible. I hear you. The stock market's at all time highs right now, which feels great. When we look at our retirement accounts, I think I still try not to look too much because I feel like it may be too good to be true. And there's some, some badness coming, coming our way with respect to the stock market and the overall economy. I think Trump's tariff policy is going to be a significant factor in that. And how we land when we get to the end of some of these 90 day spans in terms of whether we're fully backing off tariffs, whether there's going to be a massively compromised position. And I think businesses need more certainty in terms of how they are going to be operating in the current years. And I think the constant whipsawing is creating a potentially untenable situation that it's going to land us in a much worse spot than we are right now. And so I think we need to see what happens with a one big beautiful bill. Are we going to be headed for a government shutdown or is the bill largely going to be passed? Which I think, you know, if it does get passed as it is, I think the potential increase to the deficit is going to be a negative. And so I think that. I don't know, Scott. I'm rambling because I just don't know. I think there's a lot of balls in the air and I think that tariffs and the bill and the deficit are going to be a big factor in terms of how the rest of the year pans out.

[Scott Becker]

No? Holly, as always, I quite frankly appreciate the hedge approach because it's quite frankly the most rational approach. So thank you so much for joining us today. What a pleasure to visit with you as always again. Holly Buckley, remarkable leader at McGuire Woods. Thank you so much for joining us on the Back of Private Equity and Business podcast. Thank you.

[Holly Buckley]

Thank you.

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