Becker Private Equity & Business Podcast: Detailed Summary

Episode Title: 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

In this insightful episode of the Becker Private Equity & Business Podcast, host Scott Becker engages in a comprehensive discussion with Holly Buckley, a leading authority in the intersection of healthcare, private equity, and business. The conversation delves into recent regulatory changes, current trends in the deal market, and strategic priorities shaping the healthcare sector for the remainder of the year.

1. Regulatory Updates in Healthcare and Private Equity

Holly Buckley begins by outlining significant legislative developments affecting the healthcare and private equity landscape.

• Major Legislation and Deficit Spending:
  At [00:46], Holly states, "In July, the one big beautiful bill was signed into law, and with that, we saw the CBO score was finalized with an estimated $3.4 trillion in new deficit spending and 10 million Americans projected to lose health insurance."
  This highlights the substantial financial implications of the new legislation, particularly the projected increase in the national deficit and the alarming number of Americans potentially losing their health coverage.

• Tax Changes and Medicaid Cuts:
  The legislation introduces sweeping tax changes and significant Medicaid cuts, which are poised to reshape the financial landscape for healthcare providers and private equity investors alike.

• Medicare Enhancements:
  Holly notes at [02:00], "We did see within that legislation a 2.5% increase coming in 2026 for Medicare physician payments."
  This increase aims to support healthcare providers by enhancing reimbursement rates, potentially improving the financial viability of medical practices.

• Rural Hospital Fund:
  At [02:15], Holly explains, "We have the new Rural Hospital Fund, which despite its name, is a $50 billion fund designed to support a range of rural health initiatives, not just hospital-related, including clinics and telehealth providers."
  This fund is expected to stimulate growth and innovation in rural healthcare, expanding access to essential services through clinics and telehealth solutions.

• CMS Policy Shifts:
  Emphasizing cost-efficiency, the Centers for Medicare & Medicaid Services (CMS) is implementing site-neutral payment policies and proposing the elimination of the inpatient-only list for surgeries. Additionally, more outpatient procedures are being considered for reimbursement under Ambulatory Surgical Centers (ASCs).
  Holly remarks at [02:45], "CMS is doubling down on site neutral payment policies proposing to eliminate the inpatient-only list for surgeries."

• Proposed Rules Affecting Providers:
  There are proposed reductions in reimbursement for skin substitutes, which could significantly impact wound care providers. Moreover, the home health and Durable Medical Equipment (DME) sectors are facing proposed changes related to payment updates, quality reporting, and face-to-face encounter policies.

• Government Enforcement Priorities:
  The reactivation of the False Claims Act Task Force signals a renewed focus on healthcare enforcement. At [04:10], Holly states, "The DOJ and HHS has relaunched their False Claims Act Working Group, which signals a renewed focus on healthcare enforcement."
  Key areas of scrutiny include Medicare Advantage managed care fraud, kickbacks, and pricing practices for drugs and biologics, mirroring the aggressive enforcement stance of the previous administration.

2. Industry Reactions to Legislative Changes

Scott Becker probes deeper into the industry's perception of the new legislation.

• Negative Sentiment Among Providers:
  At [03:25], Scott observes, "When I hear from industry, they were overwhelmingly very negative about this, including the physicians, the ASCs, and others."
  Providers express significant concern over Medicaid cuts, fearing increased strain on healthcare systems. The projected loss of insurance coverage for 10 million Americans is anticipated to lead to higher patient volumes in emergency rooms and exacerbate costs for hospitals and health systems.

• Impact on Rural Healthcare:
  While the Rural Hospital Fund is a positive development, Holly indicates that "the rural health aspect is seen as a little bit of a distraction, but not necessarily an equalizer for the potential damage from the loss of coverage."
  This suggests that despite targeted funding, the broader negative financial impacts of the legislation may overshadow these benefits.

• Private Equity Perspective:
  The reaction within the private equity sector is mixed. Holly explains at [04:50], "Some sectors are negatively impacted, while others see opportunities that the cuts are going to bring."
  Investors are exploring innovative solutions to support states in meeting new requirements, potentially identifying lucrative investments in areas like back-to-work programs and support systems for healthcare providers.

3. Current Trends in the Private Equity Deal Market

Transitioning to the deal market, Holly provides an optimistic outlook.

• Increased Activity in the Second Half of the Year:
  At [05:31], Holly states, "The second half of the year is getting really busy, which is terrific. We've been very active heading into the second half of the year."
  Both platform buy-side and sell-side deals are experiencing robust activity, indicating a healthy and dynamic market environment.

• Platform Deals and Sell-Side Robustness:
  The platform deal market is showing significant upticks, with sell-side opportunities remaining strong throughout the year. This balance between acquisitions and divestitures suggests a vibrant marketplace with ample opportunities for strategic investments and exits.

4. Strategic Focus for the Remainder of the Year

Looking ahead, Holly outlines the strategic priorities for her team.

• Expansion of FDA and Life Sciences Group:
  At [06:17], Holly emphasizes, "We continue to look at building out and growing our FDA and life sciences group. We've had tremendous growth and success with that group in the last 18 months and we're continuing to build that out and take that group to market."
  This focus reflects the growing importance of regulatory expertise and specialized knowledge in navigating the complexities of life sciences and FDA-related matters.

• Client Execution and Talent Development:
  Ensuring effective execution for clients as market activity increases is paramount. Additionally, expanding the talent pool to support ongoing and future initiatives remains a key priority.
  Holly summarizes, "It's really just doubling down to make sure that as our clients are getting more active for the second half of the year that we're able to really execute on that and continue to develop and build our talent pool."

Conclusion

In this episode, Holly Buckley provides a nuanced analysis of the current regulatory landscape, highlighting both challenges and opportunities arising from recent legislative changes. The discussion underscores the importance of adaptability and strategic foresight in navigating the evolving healthcare and private equity sectors. With increased deal activity and targeted strategic initiatives, stakeholders are well-positioned to capitalize on emerging trends while addressing the complexities introduced by regulatory shifts.

Notable Quotes:

• "In July, the one big beautiful bill was signed into law, and with that, we saw the CBO score was finalized with an estimated $3.4 trillion in new deficit spending and 10 million Americans projected to lose health insurance." — Holly Buckley [00:46]

• "CMS is doubling down on site neutral payment policies proposing to eliminate the inpatient-only list for surgeries." — Holly Buckley [02:45]

• "The DOJ and HHS has relaunched their False Claims Act Working Group, which signals a renewed focus on healthcare enforcement." — Holly Buckley [04:10]

• "Some sectors are negatively impacted, while others see opportunities that the cuts are going to bring." — Holly Buckley [04:50]

• "We continue to look at building out and growing our FDA and life sciences group." — Holly Buckley [06:17]

This comprehensive summary encapsulates the key discussions from the podcast episode, providing valuable insights for listeners interested in the intersections of healthcare, private equity, and business strategy.