Amber Walsh
Appearances
Becker Private Equity & Business Podcast
Healthcare Private Equity in 2025: Navigating the Pause with Amber Walsh of McGuireWoods LLP 4-16-25
That was the theme really throughout much of 2024 and early 2025. The data kind of plays out. I'll share that in a minute. But just in the past several weeks, there's been more discomfort. There's been a little bit more pausing midstream on some deals that were in motion. Definitely feeling of insecurity with volatility. None of that should be surprising to anyone. We all see it.
Becker Private Equity & Business Podcast
Healthcare Private Equity in 2025: Navigating the Pause with Amber Walsh of McGuireWoods LLP 4-16-25
It's the biggest talked about concept in the news and the market reactions. And it's playing out that way in this early part of Q2. But Q1 did end up. So as you compare Q1 2025 numbers to 2024 numbers, They are as expected outside of the hospital market, which was pretty chilled, and a couple of other sectors, digital health and technology.
Becker Private Equity & Business Podcast
Healthcare Private Equity in 2025: Navigating the Pause with Amber Walsh of McGuireWoods LLP 4-16-25
But depending on whose report you're looking at, ECG has a healthcare M&A report on number of deals. They also have a healthcare private equity component. The number of deals are up there. AlphaBridge is across the board PE, not just healthcare, number of exits up. KPMG's M&A-Report in terms of sheer dollars in healthcare deals up again.
Becker Private Equity & Business Podcast
Healthcare Private Equity in 2025: Navigating the Pause with Amber Walsh of McGuireWoods LLP 4-16-25
But like I said, that only tells part of the story, but at least that was reflective of more activity in Q1 before we really hit the end of Q1, where people started to get a little bit more nervous again.
Becker Private Equity & Business Podcast
Healthcare Private Equity in 2025: Navigating the Pause with Amber Walsh of McGuireWoods LLP 4-16-25
It's an abundance of caution, but no one is willing to go too far out on the limb in either direction, excessively negative or positive. And you can't blame anyone. It feels very, very unstable at the moment. But from my perspective, because I'm always look on the bright side person, I'm pleased with how the insecurity is kind of playing out in the deals that are pausing.
Becker Private Equity & Business Podcast
Healthcare Private Equity in 2025: Navigating the Pause with Amber Walsh of McGuireWoods LLP 4-16-25
They're not big public proclamations of a pause in deal making. These are we're talking about health care, private equity deals where the lender, the sponsor, sometimes even the seller and the investment banker are wanting to just, hey, let's just wait and see. But nobody is giving up exclusivity. It's not a big dramatic party and we're never going to do this deal.
Becker Private Equity & Business Podcast
Healthcare Private Equity in 2025: Navigating the Pause with Amber Walsh of McGuireWoods LLP 4-16-25
It's just we need to wait and see what's going to happen a little bit.
Becker Private Equity & Business Podcast
Healthcare Private Equity in 2025: Navigating the Pause with Amber Walsh of McGuireWoods LLP 4-16-25
Yeah, you're absolutely right. It can mean different things for different deals. And I suspect that of the ones that I'm involved in that have taken more of a private pause, I'm guessing at least half of those will come back online again and not even with a reprice or any major change. Just waiting to see. We've got, you know, May 7th is the next time that the Fed is supposed to react on rates.
Becker Private Equity & Business Podcast
Healthcare Private Equity in 2025: Navigating the Pause with Amber Walsh of McGuireWoods LLP 4-16-25
We have a lot of, you know, we've got the 90-day pause on tariffs. We've got lots of things that both sides are kind of looking at to assess during the pause. I don't think the pause is we're going to do nothing. It's we're really going to think about this and make sure we're real comfortable on valuation, make sure we're really comfortable.
Becker Private Equity & Business Podcast
Healthcare Private Equity in 2025: Navigating the Pause with Amber Walsh of McGuireWoods LLP 4-16-25
wo unsere Risikopunkte sind, wenn die Waffenwaffen weitergehen, wie sie sind, wie das uns beeinflusst wird, von wo wir unsere Implantate bekommen, was auch immer es ist, abhängig vom Geschäft. Aber ich denke, das wird während der Pause passieren. Und dann kommen viele wieder online. Aber es ist sicherlich keine Ein-Size-Fits-All-Situation für diese Deals.
Becker Private Equity & Business Podcast
Healthcare Private Equity in 2025: Navigating the Pause with Amber Walsh of McGuireWoods LLP 4-16-25
Absolutely is going on. And you have all that, you know, on top of everything else that you just mentioned, you have these other economic dynamics of consumer loan delinquencies are at the highest they've been in a decade. And that plays into that, you know, what does our customer patient base look like in our particular business?
Becker Private Equity & Business Podcast
Healthcare Private Equity in 2025: Navigating the Pause with Amber Walsh of McGuireWoods LLP 4-16-25
And will they, you know, continue to use our product even in healthcare, where a lot of healthcare is elective and is possible? We saw that during COVID. So I think a lot of that is going on during these periods when
Becker Private Equity & Business Podcast
Healthcare Private Equity in 2025: Navigating the Pause with Amber Walsh of McGuireWoods LLP 4-16-25
Folks felt really good coming into 2025, very optimistic, but now just need to kind of think about it and make sure they're not getting totally out ahead of themselves and, you know, are going to fall off a cliff with their acquisitions.
Becker Private Equity & Business Podcast
Healthcare Private Equity in 2025: Navigating the Pause with Amber Walsh of McGuireWoods LLP 4-16-25
Yeah, I mentioned earlier the hospital health systems market. That is particularly chilled. Kauffman Hall has a really good quarterly report. That is particularly down right now. But I think, you know, always the opportunity to come back there too.
Becker Private Equity & Business Podcast
Healthcare Private Equity in 2025: Navigating the Pause with Amber Walsh of McGuireWoods LLP 4-16-25
But as you kind of break up some of the deal activity that really was pretty strong in Q1 and you start to look at it at a subsector basis, that's one that really sticks out.
Becker Private Equity & Business Podcast
Healthcare Private Equity in 2025: Navigating the Pause with Amber Walsh of McGuireWoods LLP 4-16-25
Yeah, exactly, exactly. So we're still, you know, we will wait and see and we'll see where we are a month from now. We can come back and talk about it and see if any of these predictions ring true, if the pause becomes an unpause.
Becker Private Equity & Business Podcast
Healthcare Private Equity in 2025: Navigating the Pause with Amber Walsh of McGuireWoods LLP 4-16-25
Thank you, Scott. Like you said, Amber Walsh, Healthcare Transactions Partner at McGuire Woods. I love looking at all the data that comes back in every quarter reported from a variety of sources. It's all crunched in different ways by different reporting bodies.
Becker Private Equity & Business Podcast
Healthcare Private Equity in 2025: Navigating the Pause with Amber Walsh of McGuireWoods LLP 4-16-25
I love looking at that and comparing it to one, what we were expecting coming into that particular quarter, and two, what it feels like now that we're well into the quarter after. And I think it's a mixed bag from Q1 2025 Healthcare Private Equity Dealmaking. I think the theme for the true Q1 all the way through the end of March was the continued cautious optimism that
Becker Private Equity & Business Podcast
Healthcare Policy Under the New Administration with Amber Walsh of McGuireWoods LLP 2-5-25
Obviously, people have been closely, closely watching this. this flurry of executive activity through a host of orders and memoranda and other proclamations and activities at a moment when the campaign actually did not have a huge focus on health care. The campaign focused on the economy and immigration. But a lot of the things that we're seeing in these executive orders
Becker Private Equity & Business Podcast
Healthcare Policy Under the New Administration with Amber Walsh of McGuireWoods LLP 2-5-25
should impact the healthcare industry. And we'll talk here about the things that investors should be looking at, but that's really just starting with the moment in time where we sit.
Becker Private Equity & Business Podcast
Healthcare Policy Under the New Administration with Amber Walsh of McGuireWoods LLP 2-5-25
Yeah, so the Senate Finance Committee is comprised of 14 Republicans and 13 Democrats. And that's reflective of the fact that because the Republicans have the majority in the Senate, they get a chairmanship. And so consequently, they control.
Becker Private Equity & Business Podcast
Healthcare Policy Under the New Administration with Amber Walsh of McGuireWoods LLP 2-5-25
And people who had been opposed to the RFK nomination, including very prominently his very well-known family and, of course, Senate Democrats, had been watching Senator Cassidy. He had really been very offended. by Kennedy's anti-vaccine campaign.
Becker Private Equity & Business Podcast
Healthcare Policy Under the New Administration with Amber Walsh of McGuireWoods LLP 2-5-25
And he was the one that many people thought that if they were going to have a Republican defector from the nomination within the Senate Finance Committee, that it might be Senator Cassidy. Turns out he ultimately got comfortable. Robert
Becker Private Equity & Business Podcast
Healthcare Policy Under the New Administration with Amber Walsh of McGuireWoods LLP 2-5-25
Kennedy gave him assurances that he wasn't going to take down the Children's Health Vaccine Program and some other things that are quite precious to Senator Cassidy as a physician. And so ultimately, the Senate Finance Committee voted straight down the line on party lines. So what that means now is it comes out the Senate Finance Committee to go to the whole Senate.
Becker Private Equity & Business Podcast
Healthcare Policy Under the New Administration with Amber Walsh of McGuireWoods LLP 2-5-25
Oh, absolutely. And this is a really interesting moment because you have this. tuberculosis outbreak that's happening in Kansas. And you also have the administration, as part of the proclamations that have been made since January 20th, saying to HHS, your job is to control chronic disease in this world as part of the Make America Healthy Again campaign.
Becker Private Equity & Business Podcast
Healthcare Policy Under the New Administration with Amber Walsh of McGuireWoods LLP 2-5-25
I do not expect there to really be, and this is one of the things that Senator Cassidy really had to get assurances from, is I don't think anybody really expects the rest of the vaccine programs, set aside COVID, to really be impacted, despite all the things that we're seeing, many of which are creating a ton of chaos.
Becker Private Equity & Business Podcast
Healthcare Policy Under the New Administration with Amber Walsh of McGuireWoods LLP 2-5-25
Absolutely. Well, we are sitting here right at this moment, just within the past couple of hours, that Robert F. Kennedy's confirmation made it through the Senate Finance Committee with a 13 to 14 split. And it's very interesting because it sets up some health policy thinking that you should be watching. A lot of people had been closely watching what Senator Cassidy out of Louisiana would do.
Becker Private Equity & Business Podcast
Healthcare Policy Under the New Administration with Amber Walsh of McGuireWoods LLP 2-5-25
He was the Republican that sits on the Senate Finance Committee that was on the fence. And as people may or may not know, there's actually four physicians in the Senate. They comprise what is known as the Senate Doc Caucus. They happen to all four be Republican right now. And three of the four sit on the Senate Finance Committee. Cassidy was very closely watched.
Becker Private Equity & Business Podcast
Healthcare Policy Under the New Administration with Amber Walsh of McGuireWoods LLP 2-5-25
Ultimately, he gave his support to Kennedy and that just passed out of committee. And with Cassidy's support, he is expected to now get the nomination once it actually goes to the full Senate. So we come to this moment right here, assuming now that Robert F. Kennedy will be the secretary of HHS. And soon thereafter, Mehmet Oz, another physician, will probably also be the head of CMS.
Becker Private Equity & Business Podcast
Leading Across Generations: Insights from Amber Walsh of McGuireWoods LLP 4-1-25
Thanks, Scott.
Becker Private Equity & Business Podcast
Leading Across Generations: Insights from Amber Walsh of McGuireWoods LLP 4-1-25
But that's why it's really top of mind is because I just came off of this experience and also happened to be the person in the room who smack dab in the middle of that group. I am right in the middle of the five generations and as a classic Gen Xer. And so I have a lot of different perspectives in both the generations before me and the generations after me at the firm.
Becker Private Equity & Business Podcast
Leading Across Generations: Insights from Amber Walsh of McGuireWoods LLP 4-1-25
And that's why I'm so interested in the topic.
Becker Private Equity & Business Podcast
Leading Across Generations: Insights from Amber Walsh of McGuireWoods LLP 4-1-25
We have, no, I would say we have four and a little bit of the fifth generation. So if you take the generations as the eldest of the generation, the pre-baby boomers, you can call it the silent generation, the greatest generation, the traditionalist, whatever you want to label that. It is typically defined as before 1946. We have very few attorneys in that age bracket at the firm.
Becker Private Equity & Business Podcast
Leading Across Generations: Insights from Amber Walsh of McGuireWoods LLP 4-1-25
They are senior attorneys, but they are still invited to and attending retreats. Some of our former firm leadership. And then, of course, we have baby boomers. We have Gen X, which is my generation, defined as roughly born between 65 and 80. And I'm born in 1976. I'm right in the middle of that. Millennials born, depending on the definition, in the early 80s to the late 90s.
Becker Private Equity & Business Podcast
Leading Across Generations: Insights from Amber Walsh of McGuireWoods LLP 4-1-25
And then we do have Gen Z. That's my son's age bracket, my son and my daughter, who are high schoolers. But we now have... People graduating from law school, getting their JDs, practicing as Gen Z. So we actually very technically have five in the law firm.
Becker Private Equity & Business Podcast
Leading Across Generations: Insights from Amber Walsh of McGuireWoods LLP 4-1-25
And of course, in other industries, when you work at a younger and an older age, it is even more pronounced that you have truly, truly all five generations represented.
Becker Private Equity & Business Podcast
Leading Across Generations: Insights from Amber Walsh of McGuireWoods LLP 4-1-25
Well, I'm actually going to start with that one that you just said that you feel like a little bit of a father sometimes. I'm actually going to hone in on that because I think this is one of the most interesting things that. There is an interesting dynamic if you are working with the generation that is of the same age as your parent or the same age as your child.
Becker Private Equity & Business Podcast
Leading Across Generations: Insights from Amber Walsh of McGuireWoods LLP 4-1-25
I think we have a tendency, and this can be a negative thing, we have to get over this as leaders and as coworkers. We have a tendency to look at somebody and kind of put those features on and put ourselves in that parent-child relationship in both directions.
Becker Private Equity & Business Podcast
Leading Across Generations: Insights from Amber Walsh of McGuireWoods LLP 4-1-25
And I think that one of the beauties, now that we have, for the first time ever, five generations in the workforce, you have an opportunity to take the me out of the equation, the sandwich generation, the middle generation out. And you don't have that parent-child dynamic anymore. And instead, we have this opportunity with the wide age ranges.
Becker Private Equity & Business Podcast
Leading Across Generations: Insights from Amber Walsh of McGuireWoods LLP 4-1-25
We have an opportunity now for baby boomers to work with Gen Z or millennials and get away from the parent-child, which is not necessarily a bad thing because you feel very committed to someone's success. But it is a little bit of a different dynamic.
Becker Private Equity & Business Podcast
Leading Across Generations: Insights from Amber Walsh of McGuireWoods LLP 4-1-25
And sometimes that more of a grandparent-grandchild relationship or just being able to view each other as mere colleagues without the baggage that can come sometimes from having parented that particular age very recently, I think that can be really healthy. And you also have an interesting dynamic kind of in a very similar vein where
Becker Private Equity & Business Podcast
Leading Across Generations: Insights from Amber Walsh of McGuireWoods LLP 4-1-25
We now have this older generation, the silent generation, the baby boomers, who have spent the past 20 years being taught by, happily taught technology by their grandkids. It's an interesting dynamic that was not the case when I was growing up so much.
Becker Private Equity & Business Podcast
Leading Across Generations: Insights from Amber Walsh of McGuireWoods LLP 4-1-25
Yeah, Scott, thank you. I love this topic, and it's really front of mind for me for a variety of reasons. But having just come back from a really fun all-attorney retreat by our firm – That, as you know, is very unique. Most large law firms have partner retreats every year, every other year.
Becker Private Equity & Business Podcast
Leading Across Generations: Insights from Amber Walsh of McGuireWoods LLP 4-1-25
that grandparents and grandchildren have this different and unique kind of teaching empowerment relationship where the younger generation understands how to delight in and get some personal satisfaction from being able to teach and expand the older generation access to technology and use of technology. That's a very simple and obvious kind of teaching upward observation.
Becker Private Equity & Business Podcast
Leading Across Generations: Insights from Amber Walsh of McGuireWoods LLP 4-1-25
But I think it's really neat and to loop back when you can, some of the most effective ways that that happens is when you, when the middle generation is not doing it all, it is, the older colleagues and the younger colleagues teaching each other, working with each other, and they've done that because they've been doing that in their own families and their own lives for many, many years.
Becker Private Equity & Business Podcast
Leading Across Generations: Insights from Amber Walsh of McGuireWoods LLP 4-1-25
Yeah, I think I would make an observation on internal value and then external value. So internally. It really forces you when you are working with people of all different types of backgrounds. But right now we're talking about different ages. It really forces you to think differently and to be innovative in a variety of ways. You will not succeed as a leader or a member of a team.
Becker Private Equity & Business Podcast
Leading Across Generations: Insights from Amber Walsh of McGuireWoods LLP 4-1-25
If you cannot figure out a way to communicate effectively with every single member of the team, and there are so many classically obvious generational differences in communication from just nomenclature to, to analogies and references to just the form and the media and the level of formality that people communicate. The differences between comfort with texting
Becker Private Equity & Business Podcast
Leading Across Generations: Insights from Amber Walsh of McGuireWoods LLP 4-1-25
and texting like I do, which is very precise. I use good grammar. I capital letters and punctuation versus the way that my kids text and they're very bright, but they, they just laugh at good grammar and text that is becoming part of the workplace now.
Becker Private Equity & Business Podcast
Leading Across Generations: Insights from Amber Walsh of McGuireWoods LLP 4-1-25
And you have to be able as a leader and a member of a team, you've got to be able to communicate in all these different ways and find a way that's comfortable for everyone. And forcing you to be innovative is a really good thing. You also have to find ways to motivate the different generations. There's been scads and scads of writings about
Becker Private Equity & Business Podcast
Leading Across Generations: Insights from Amber Walsh of McGuireWoods LLP 4-1-25
But very few firms do an all-attorney retreat of every single attorney in the firm, every office, wherever they sit. We have not done that as a firm in more than 15 years. It's very unusual. But it was really fun to see everyone together crossing just like the rest of the workforce in our firm. We also have five generations of lawyers.
Becker Private Equity & Business Podcast
Leading Across Generations: Insights from Amber Walsh of McGuireWoods LLP 4-1-25
the different things that millennials expect from their employer and from a career than what even Gen Z expects. There's a bit of a pendulum swinging back, which is very interesting. But you have to find ways. to motivate. I mean, you literally even have to find ways to do math differently because we all learned math differently.
Becker Private Equity & Business Podcast
Leading Across Generations: Insights from Amber Walsh of McGuireWoods LLP 4-1-25
But I think this is such a great opportunity despite the challenges. It is a challenge that gives you the opportunity to innovate and improve yourself, which of course will ultimately have external value.
Becker Private Equity & Business Podcast
Leading Across Generations: Insights from Amber Walsh of McGuireWoods LLP 4-1-25
Yeah, I think just asking questions is, as you know, people love to just talk about their perspectives. And you cannot make assumptions just because someone is of a certain age. You cannot assume what they want. what it's going to take to motivate them and make them happy in their career.
Becker Private Equity & Business Podcast
Leading Across Generations: Insights from Amber Walsh of McGuireWoods LLP 4-1-25
You can't assume that you know more than them about a particular topic just because you've been practicing longer or you are of a certain generation. Just asking the questions and having the conversations. And frankly, it's what I loved about our retreat, our all-attorney retreats,
Becker Private Equity & Business Podcast
Leading Across Generations: Insights from Amber Walsh of McGuireWoods LLP 4-1-25
was just putting people together to be able to have conversations that you might not otherwise have and then using this i think my last this is both an observation but a piece of advice using these differences to be effective externally because of course we all build internal teams
Becker Private Equity & Business Podcast
Leading Across Generations: Insights from Amber Walsh of McGuireWoods LLP 4-1-25
and want to give comfort and success and all of that to our teams internally, because ultimately we have a job to do. And in our world, it's serving clients and meeting our clients' needs. And so you take what you learn internally and these skills, these great things that come from multi-generational teams, and you use them externally.
Becker Private Equity & Business Podcast
Leading Across Generations: Insights from Amber Walsh of McGuireWoods LLP 4-1-25
so that you can prepare better communications that meet a broader range of your client base, that you're thinking about different possibilities and outcomes because you come from different experiences. And it just kind of gives a new energy to a team. You can put together a team that looks different because of the different generations. And we have a perfect example right now.
Becker Private Equity & Business Podcast
Leading Across Generations: Insights from Amber Walsh of McGuireWoods LLP 4-1-25
in the media with Representative Ocasio-Cortez and Senator Sanders. I don't care where you fall on the political spectrum. You've got to get a huge kick out of their energy together and their campaign and all that they're doing. There's a 50-year difference between AOC and Bernie Sanders.
Becker Private Equity & Business Podcast
Leading Across Generations: Insights from Amber Walsh of McGuireWoods LLP 4-1-25
And yet the energy they bring together is just really interesting, and they're getting some action and some vibe for that. So set aside where you might fall politically, it is a good example of a multi-generational message and team that is kind of working a little bit.
Becker Private Equity & Business Podcast
Leading Across Generations: Insights from Amber Walsh of McGuireWoods LLP 4-1-25
Yeah, I'm glad you asked that. I am thinking a lot about the way that we make our teams and the way that we choose even the firm committees and firm leadership and making sure that as we think about the different perspectives, we're also getting different generational perspectives and that when we put people in all of these leadership positions and in all of these thinking bodies within the firm,
Becker Private Equity & Business Podcast
Leading Across Generations: Insights from Amber Walsh of McGuireWoods LLP 4-1-25
And it was really top of mind for me as we were planning the content, planning the socializing, planning what is important and impactful and meaningful to talk about when you have five generations of attorneys You and I literally have colleagues now who were born after 2000, which is just absolutely wild and really, really cool.
Becker Private Equity & Business Podcast
Leading Across Generations: Insights from Amber Walsh of McGuireWoods LLP 4-1-25
that you have some really young perspectives as well, and you're not just hitting that middle bandwidth. So that's something that's really top of mind for me right now is to take these things that we know to be true. We see them within the working teams, but you also do that within some of the firm governance. So that would be kind of, for me personally,
Becker Private Equity & Business Podcast
Leading Across Generations: Insights from Amber Walsh of McGuireWoods LLP 4-1-25
That next level of really, really capitalizing on the benefit of this broad range that we have in the firm right now.
Becker Private Equity & Business Podcast
The Ongoing Shift to Outpatient Care: Key Trends and Investor Insights with Amber Walsh of McGuireWoods LLP 5-8-25
Yeah, so I'll start with the building. It's really interesting. I mean, we're sitting here in the from traditional commercial real estate space for the past several years, obviously triggered a lot by COVID. And yet at the same time, while that's the macro trend across commercial real estate, you see the proliferation of medical office buildings and that construction growth continuing to go up.
Becker Private Equity & Business Podcast
The Ongoing Shift to Outpatient Care: Key Trends and Investor Insights with Amber Walsh of McGuireWoods LLP 5-8-25
And seeing it more, JLL reports on this, obviously one of the big brokers, reports on this frequently, and you're now even seeing off-campus medical office buildings taking over on on-campus medical office building development.
Becker Private Equity & Business Podcast
The Ongoing Shift to Outpatient Care: Key Trends and Investor Insights with Amber Walsh of McGuireWoods LLP 5-8-25
And in large part, it's this response to the increased opportunity for outpatient therapies, the move for so many things, not just traditional ASCs or elective surgery, but we're talking about drug administration in the form of infusion centers. We're talking about mental health, outpatient programs, all sorts of things.
Becker Private Equity & Business Podcast
The Ongoing Shift to Outpatient Care: Key Trends and Investor Insights with Amber Walsh of McGuireWoods LLP 5-8-25
And one of the interesting angles of that, and I'm dealing with this right now in a deal I'm working on, is a health system that is so confident that they're going to be able to fill up this massive MOB that they're building. They don't have the tenants selected yet. They don't know exactly what's going to go in there, but they're so confident
Becker Private Equity & Business Podcast
The Ongoing Shift to Outpatient Care: Key Trends and Investor Insights with Amber Walsh of McGuireWoods LLP 5-8-25
there's enough community need on an outpatient basis that they're going ahead and making that MOB investment, which I find really fascinating. It's just one of those aspects that this trend continues to push and impact other industries.
Becker Private Equity & Business Podcast
The Ongoing Shift to Outpatient Care: Key Trends and Investor Insights with Amber Walsh of McGuireWoods LLP 5-8-25
Yeah, you do have hospitals repurposing spaces to taking inpatient space and repurposing it to the extent that you can. And there are some states that the flexibility that they gave on hospital licensure and space use that they gave granted during COVID, some states, when they returned to normal in a post-COVID world, kept a little bit more flexibility for that.
Becker Private Equity & Business Podcast
The Ongoing Shift to Outpatient Care: Key Trends and Investor Insights with Amber Walsh of McGuireWoods LLP 5-8-25
And it's actually allowed hospitals to repurpose some of their space for outpatient use. And that helps. And it's not perfect. And that's not the case everywhere in all states, but where it's an opportunity, it allows the hospital to keep that space that maybe isn't quite as needed for inpatient and repurpose it for different things.
Becker Private Equity & Business Podcast
The Ongoing Shift to Outpatient Care: Key Trends and Investor Insights with Amber Walsh of McGuireWoods LLP 5-8-25
Hi, Scott. Thanks for having me on. Today, I am really thinking about, and in particular, because I've read a couple of articles and working on a couple of deals that have me thinking again about the shift to outpatient care from inpatient care. And as you and I both know, this has been a trend that has gone on for decades. There is nothing new with the move to outpatient.
Becker Private Equity & Business Podcast
The Ongoing Shift to Outpatient Care: Key Trends and Investor Insights with Amber Walsh of McGuireWoods LLP 5-8-25
I think there's a couple of different angles to it. I mean, you can look at it in a really simplistic basis of which particular specialties and therapies are growing at the fastest rate. I think there's a pretty significant focus on endocrinology with the development of GLP-1s. That's the fastest growing right now.
Becker Private Equity & Business Podcast
The Ongoing Shift to Outpatient Care: Key Trends and Investor Insights with Amber Walsh of McGuireWoods LLP 5-8-25
But then you have all of these other outpatient therapies I mentioned earlier, the infusion centers, that is a big one as well. So that's looking at it simplistically of just what is kind of hot and growing right now.
Becker Private Equity & Business Podcast
The Ongoing Shift to Outpatient Care: Key Trends and Investor Insights with Amber Walsh of McGuireWoods LLP 5-8-25
But there's the additional angle to it, which is the outpatient therapies, not just as a direct investment and not just outpatient therapies, I should say, the surgery centers and all of the outpatient provider world. There's not just the direct investment investment.
Becker Private Equity & Business Podcast
The Ongoing Shift to Outpatient Care: Key Trends and Investor Insights with Amber Walsh of McGuireWoods LLP 5-8-25
There's the additional angle of how do you bring those providers into your existing platform growth strategy, either in a contractual relationship where you have more bundled payments and value-based care, to if you're not making a direct investment, you can partner with them to lower the cost and take risks together.
Becker Private Equity & Business Podcast
The Ongoing Shift to Outpatient Care: Key Trends and Investor Insights with Amber Walsh of McGuireWoods LLP 5-8-25
how you develop those additional ancillaries as an alignment strategy with your employed physicians. If you are a private equity investor, looking at different revenue streams and also different cost centers, you can look at it from the angle as a private equity investor, look at it from the angle of employee and staff and physician retention. There's a lot of data around employee satisfaction.
Becker Private Equity & Business Podcast
The Ongoing Shift to Outpatient Care: Key Trends and Investor Insights with Amber Walsh of McGuireWoods LLP 5-8-25
when they get to make moves and have personal flexibility and work in different environments like we're talking about. And then you can look at it from the angle of how it can increase and provide an opportunity to adhere to an entirely new patient base because these outpatient location developments
Becker Private Equity & Business Podcast
The Ongoing Shift to Outpatient Care: Key Trends and Investor Insights with Amber Walsh of McGuireWoods LLP 5-8-25
often help create access points for patients that otherwise were not, they simply were not going to get a particular diagnostic or treatment because they had to travel too far or they had a fear of going to the hospital. There's all sorts of impediments for why patients don't receive the care that they may have the right to receive.
Becker Private Equity & Business Podcast
The Ongoing Shift to Outpatient Care: Key Trends and Investor Insights with Amber Walsh of McGuireWoods LLP 5-8-25
And you can look at it as an investor from all these different angles and But it starts with just embracing the almost constant reality that there's a move to the outpatient setting that you need to understand where it's really happening, where it's happening hot, and where you might also expect a little volatility maybe in the reimbursement for that.
Becker Private Equity & Business Podcast
The Ongoing Shift to Outpatient Care: Key Trends and Investor Insights with Amber Walsh of McGuireWoods LLP 5-8-25
Because that's a whole other angle where there's some reimbursement that's been really steady on an outpatient basis. other that's been more spiky. It's been really attractive for a couple of years. And then payers have kind of gotten a handle on it and brought the reimbursement down. So there's all these different elements to it.
Becker Private Equity & Business Podcast
The Ongoing Shift to Outpatient Care: Key Trends and Investor Insights with Amber Walsh of McGuireWoods LLP 5-8-25
And it's a big concept, but it's really interesting and exciting and an opportunity for investors to constantly be thinking about.
Becker Private Equity & Business Podcast
The Ongoing Shift to Outpatient Care: Key Trends and Investor Insights with Amber Walsh of McGuireWoods LLP 5-8-25
Exactly. And really honing in on What you're going to do, what you're going to do well, and what you can expect in terms of competition, but also in terms of reimbursement in those areas and how you can make sure that it's going to be sustainable. That's a very interesting angle on this because as you have some of the very expensive procedures, diagnostics and procedures both,
Becker Private Equity & Business Podcast
The Ongoing Shift to Outpatient Care: Key Trends and Investor Insights with Amber Walsh of McGuireWoods LLP 5-8-25
other than I am constantly amazed that there are new factors driving the move to outpatient, and there's more and new kind of repercussions and impacts of that move to the outpatient setting. And it really plays into a lot of investors' decision-making and
Becker Private Equity & Business Podcast
The Ongoing Shift to Outpatient Care: Key Trends and Investor Insights with Amber Walsh of McGuireWoods LLP 5-8-25
that used to be inpatient only and as they move to the outpatient setting and as they continue to move through the continuum of outpatient from an ASC to an office-based procedure room, you will sometimes have these periods of really attractive or really stagnant reimbursement that you have to be prepared for and really understand is what you're looking at
Becker Private Equity & Business Podcast
The Ongoing Shift to Outpatient Care: Key Trends and Investor Insights with Amber Walsh of McGuireWoods LLP 5-8-25
on a recent income statement and payer mix is that sustainable. Obviously that's what investors do across the board all the time, but looking at it as a micro level at a specific CPT code, because some of them are so vulnerable and they kind of pop off a page when you really think about it and kind of dig in as to how sustainable it is often when it's making that move from inpatient only to
Becker Private Equity & Business Podcast
The Ongoing Shift to Outpatient Care: Key Trends and Investor Insights with Amber Walsh of McGuireWoods LLP 5-8-25
to a different lower acuity setting.
Becker Private Equity & Business Podcast
The Ongoing Shift to Outpatient Care: Key Trends and Investor Insights with Amber Walsh of McGuireWoods LLP 5-8-25
Yeah, that's exactly right. And clearly there's an impact on health systems in this move. And you get very different reactions from health systems over it. Some that embrace it use the opportunity, like I mentioned, the health system I'm dealing with right now that's building an MOB, kind of of a, if we build it, it will come. They know they're going to be able to fill it. They're confident.
Becker Private Equity & Business Podcast
The Ongoing Shift to Outpatient Care: Key Trends and Investor Insights with Amber Walsh of McGuireWoods LLP 5-8-25
versus resisting it you know embracing more of a joint venture model embracing more bundled care you know some unique approaches because they know what's going to come out of the inpatient setting anyways but it obviously causes some financial strain for a lot and you see inpatient days going down over time and and that can be hard to manage hard to deal with that's just
Becker Private Equity & Business Podcast
The Ongoing Shift to Outpatient Care: Key Trends and Investor Insights with Amber Walsh of McGuireWoods LLP 5-8-25
It's one of the realities of this move.
Becker Private Equity & Business Podcast
The Ongoing Shift to Outpatient Care: Key Trends and Investor Insights with Amber Walsh of McGuireWoods LLP 5-8-25
Absolutely. And of course, it's geography dependent. You see a lot more confidence in the Sunbelt with growth in both the baby boomer population. I mean, there's all sorts of different factors that go into it. But you're absolutely right. I mean, I think that's how this particular system is feeling. And I hope they're right. Yeah.
Becker Private Equity & Business Podcast
The Ongoing Shift to Outpatient Care: Key Trends and Investor Insights with Amber Walsh of McGuireWoods LLP 5-8-25
Thank you, Scott.
Becker Private Equity & Business Podcast
The Ongoing Shift to Outpatient Care: Key Trends and Investor Insights with Amber Walsh of McGuireWoods LLP 5-8-25
So while there's nothing new about that shift, it almost feels like a permanent reality that's been going on for decades that has become relatively reliable. There's just these other interesting angles to it that I'm really interested in thinking about today.
Becker Private Equity & Business Podcast
Amber Walsh on Industry Insights, Fresh Perspectives, and Inspiration from the McGuireWoods Healthcare PE Conference 5-23-25
all together to share our independent perspectives of what we're seeing in the market, but where we think things are going as well. And I would say that the overall characterization of what people are feeling is similar to what I've expressed to you over the past several months is measured optimism. That's a phrase that we continue to hear along with some other different themes.
Becker Private Equity & Business Podcast
Amber Walsh on Industry Insights, Fresh Perspectives, and Inspiration from the McGuireWoods Healthcare PE Conference 5-23-25
But I love this opportunity to get together, kind of take temperature. And yes, our own feelings influence each other's feelings. That's just very natural. But I came away relatively positive on the investment community standpoint, but really thankful to have the opportunity for new perspectives. So in addition to measured optimism, for me, new perspectives was a theme that
Becker Private Equity & Business Podcast
Amber Walsh on Industry Insights, Fresh Perspectives, and Inspiration from the McGuireWoods Healthcare PE Conference 5-23-25
settled on me throughout the conference including through our two keynoters one of whom you were able to moderate really in a wonderful dialogue thank you and take a moment sort of on what you sort of saw what you're sort of thinking i know we're talking about uh
Becker Private Equity & Business Podcast
Amber Walsh on Industry Insights, Fresh Perspectives, and Inspiration from the McGuireWoods Healthcare PE Conference 5-23-25
Yeah, absolutely. So Anousheh gave a really interesting perspective. She has literally had a view of that very few humans on this planet have had, which is from space. She left the atmosphere. She didn't just do a suborbital mission that you're now seeing in some of the space exploration. She was able to see the Earth in a completely different perspective. And there are so few people
Becker Private Equity & Business Podcast
Amber Walsh on Industry Insights, Fresh Perspectives, and Inspiration from the McGuireWoods Healthcare PE Conference 5-23-25
who will ever get the opportunity to do that. And it was remarkable to hear her. It really is a metaphor for the different types of perspectives that I also kept thinking about as the two-day conference went along. Her perspective of being there and looking at the earth for the first time. And despite what she had been told her entire life, and we're all told that
Becker Private Equity & Business Podcast
Amber Walsh on Industry Insights, Fresh Perspectives, and Inspiration from the McGuireWoods Healthcare PE Conference 5-23-25
Was she expected to see more delineation and lines and clear borders? You don't see that from space. Now, all of us have seen pictures of the Earth from space. That's one thing that while most of us will never experience it in person, yes, of course, we've seen satellite images.
Becker Private Equity & Business Podcast
Amber Walsh on Industry Insights, Fresh Perspectives, and Inspiration from the McGuireWoods Healthcare PE Conference 5-23-25
But hearing her talk about that very impactful moment and that immediate shift in perspective, and when it comes from someone who herself immigrated when she was very young, as a young teenager from Iran, not speaking English, coming to the United States, going through the educational system and university system and what she grew into.
Becker Private Equity & Business Podcast
Amber Walsh on Industry Insights, Fresh Perspectives, and Inspiration from the McGuireWoods Healthcare PE Conference 5-23-25
When you hear about that first moment from her lens, looking back at the earth, realizing the lack of borders, all of the possibility of And everything that she went through herself to get to that point, it was just remarkable and quite uplifting at a moment where we all need to be thinking about things beyond ourselves and our little microcosms.
Becker Private Equity & Business Podcast
Amber Walsh on Industry Insights, Fresh Perspectives, and Inspiration from the McGuireWoods Healthcare PE Conference 5-23-25
It was a really great, uplifting moment in the midst of talking about healthcare investing. And you would not think that those two concepts would align terribly closely, but they really do because everyone needs inspiration like that and a little bit of perspective shift. And I think everyone appreciated hearing that from her.
Becker Private Equity & Business Podcast
Amber Walsh on Industry Insights, Fresh Perspectives, and Inspiration from the McGuireWoods Healthcare PE Conference 5-23-25
Yeah, thank you, Scott. This is one of my favorite events that I get to help organize along with several of our other partners, Holly Buckley, Jeff Cockrell, yourself, Bart Walker, lots of people at the firm involved in this. But it's one of my favorite things that I get to participate in every year. We started the planning. Really, we've already chosen the dates for next year.
Becker Private Equity & Business Podcast
Amber Walsh on Industry Insights, Fresh Perspectives, and Inspiration from the McGuireWoods Healthcare PE Conference 5-23-25
Yeah, this actually is one of the things we always encourage our young attorneys as they are first starting to come out of the office, come out of their individual teams and client matters and projects and step into the realm of conference attendance. We always encourage them to dive in, listen. Don't be multitasking and focusing on your own client needs at that moment.
Becker Private Equity & Business Podcast
Amber Walsh on Industry Insights, Fresh Perspectives, and Inspiration from the McGuireWoods Healthcare PE Conference 5-23-25
You are there to hear new perspectives. There is no point in going to any gathering of professionals, be it in this case, healthcare private equity. Sometimes you have a gathering of healthcare lawyers when you go to your conference of CIOs or hospital executives, whatever it is, you are not there to hear the same thing and to have your own thoughts echoed back to you.
Becker Private Equity & Business Podcast
Amber Walsh on Industry Insights, Fresh Perspectives, and Inspiration from the McGuireWoods Healthcare PE Conference 5-23-25
You're there to hear new perspectives. That's the value of those sorts of gatherings. But it's not natural sometimes. We really have to encourage people to experience and listen and ask questions about And I'll give you a perfect example. I'll give you two examples from the conference. One is the perspective of the, what we were calling the Titans of industry.
Becker Private Equity & Business Podcast
Amber Walsh on Industry Insights, Fresh Perspectives, and Inspiration from the McGuireWoods Healthcare PE Conference 5-23-25
That wasn't the official panel name, but you had, you know, remarkable hospital executives like JP Gallagher, you had healthcare futurists giving all of these different perspectives of where they sit in the industry. And it's, Some of it is reflective of one another, but much of it is not. They have different viewpoints.
Becker Private Equity & Business Podcast
Amber Walsh on Industry Insights, Fresh Perspectives, and Inspiration from the McGuireWoods Healthcare PE Conference 5-23-25
And it's really the whole point of being there is to take those in and then take it back to your own organization and figure out what is meaningful to you that you can implement in your investment strategy, the way you run your teams, etc. The other example I'll give is Lance Armstrong's was our first day keynote moderated by our partner, Holly Buckley.
Becker Private Equity & Business Podcast
Amber Walsh on Industry Insights, Fresh Perspectives, and Inspiration from the McGuireWoods Healthcare PE Conference 5-23-25
And just listening to his different perspective on his story, including not just the part with Oprah and the scandal and all that piece that was interesting, but just his perspective on who he is as an athlete and how he defined himself early on as a swimmer and a triathlete, excuse me, less of a cyclist.
Becker Private Equity & Business Podcast
Amber Walsh on Industry Insights, Fresh Perspectives, and Inspiration from the McGuireWoods Healthcare PE Conference 5-23-25
These shifts in perspective are so interesting and the whole point of attending conferences like this, in my view.
Becker Private Equity & Business Podcast
Amber Walsh on Industry Insights, Fresh Perspectives, and Inspiration from the McGuireWoods Healthcare PE Conference 5-23-25
But really, the intensive content planning, about nine months out. And we grew from a first luncheon for a couple of hours to a two-day conference with nearly 1,000 attendees. And it's been in that format for several years. What I love about the conference is it takes some different forms every year. in terms of what the focus is and what the vibe is.
Becker Private Equity & Business Podcast
Amber Walsh on Industry Insights, Fresh Perspectives, and Inspiration from the McGuireWoods Healthcare PE Conference 5-23-25
Absolutely. And it's just such a great opportunity to take two days out of our daily lives, our daily rigor. Yes, we still have to make sure we're responsive to clients and keep deals moving all throughout a two-day event like that. But if you can allow yourself to just sink in and enjoy and hear the story and take just tidbits of back for yourself on what you can learn from that.
Becker Private Equity & Business Podcast
Amber Walsh on Industry Insights, Fresh Perspectives, and Inspiration from the McGuireWoods Healthcare PE Conference 5-23-25
I love the word that you just used, the redemptive moments. Those are so helpful and there's all sorts of different perspectives that everyone brings on all the different panels, be it a deep dive into the dental industry or talking about lending terms or something much more, you know, ephemeral as that sort of fall from grace that Lance was talking about.
Becker Private Equity & Business Podcast
Amber Walsh on Industry Insights, Fresh Perspectives, and Inspiration from the McGuireWoods Healthcare PE Conference 5-23-25
It's all really valuable, and it's why you attend a conference like that, and it's why I came back feeling invigorated and ready to get back to daily life.
Becker Private Equity & Business Podcast
Amber Walsh on Industry Insights, Fresh Perspectives, and Inspiration from the McGuireWoods Healthcare PE Conference 5-23-25
And very much in the same way that we talk about JP Morgan reflecting the vibe of the healthcare private equity industry every year in January, our conference does the same thing where you're able to get investors, healthcare company executives, those of us who serve the industry as lawyers, bankers, etc.,
Becker Private Equity & Business Podcast
Healthcare Private Equity Carveouts: Trends and Insights with Amber Walsh of McGuireWoods LLP 3-7-25
type of deal, which I'm really interested in today.
Becker Private Equity & Business Podcast
Healthcare Private Equity Carveouts: Trends and Insights with Amber Walsh of McGuireWoods LLP 3-7-25
Yeah, that's absolutely right. All sorts of different kinds of deal structures. But on the carve-out, why it's so attractive is that we've talked so much in the past 18 months or so about the challenges of getting more traditional buyout deals done, particularly requiring debt.
Becker Private Equity & Business Podcast
Healthcare Private Equity Carveouts: Trends and Insights with Amber Walsh of McGuireWoods LLP 3-7-25
and the level of diligence involved and some instability in the regulatory market, but yet you also had these fully funded funds with dry powder that needs to deploy capital. And so even though everyone is expecting and already seeing that loosening up and getting more active back again in 2025, what the carve-out market did was allow private equity buyers
Becker Private Equity & Business Podcast
Healthcare Private Equity Carveouts: Trends and Insights with Amber Walsh of McGuireWoods LLP 3-7-25
to acquire and reinvigorate assets that were considered a little more stable, often cash flow positive. They are not necessarily troublesome assets for the divesting company. it just happens that the divesting company no longer really considered that particular division or asset part of its strategic plan and vision.
Becker Private Equity & Business Podcast
Healthcare Private Equity Carveouts: Trends and Insights with Amber Walsh of McGuireWoods LLP 3-7-25
And so what you see is these mega companies streamlining, choosing to divest what they consider non-core assets, but they're really attractive assets for private equity buyers that are really stable and are going to perform well in diligence. And it just,
Becker Private Equity & Business Podcast
Healthcare Private Equity Carveouts: Trends and Insights with Amber Walsh of McGuireWoods LLP 3-7-25
Yeah, that's absolutely right. I mean, of course, every deal has its own features, but that is quite often what it is. It's just the investor makes a choice and there's a whole market and these private equity funds where they've got to answer to their LPs, they need to deploy their capital, they can be very attractive. And there's a real potential for high returns, although there's some challenges
Becker Private Equity & Business Podcast
Healthcare Private Equity Carveouts: Trends and Insights with Amber Walsh of McGuireWoods LLP 3-7-25
to those as well, because depending on really how embedded that particular division or asset is to the rest of the company from which it is being divested, it requires the buyer to diligence in a whole new way sometimes. Sometimes it's hard to diligence when it's so core to another business line. And it also can be hard to operationalize
Becker Private Equity & Business Podcast
Healthcare Private Equity Carveouts: Trends and Insights with Amber Walsh of McGuireWoods LLP 3-7-25
Yeah, absolutely. And really focused particularly today on healthcare private equity carve-outs as a particular deal type and M&A strategy. And What a carve-out is is not your traditional sponsor-to-sponsor transaction where one sponsor sells out its equity to another sponsor.
Becker Private Equity & Business Podcast
Healthcare Private Equity Carveouts: Trends and Insights with Amber Walsh of McGuireWoods LLP 3-7-25
and instantaneously kind of take over and run it as the buyer. And so a lot of times you'll need some very serious transition planning, but there's a lot of potential upside in those deals.
Becker Private Equity & Business Podcast
Healthcare Private Equity Carveouts: Trends and Insights with Amber Walsh of McGuireWoods LLP 3-7-25
Yeah, that's exactly right. And I guess I'd give you just, Three more observations is within healthcare carve-outs, we definitely last year saw them in all subsectors of healthcare. So it's not just pharma and biotech, which may be the first things that come to mind, but we saw it in traditional services. We also aren't just seeing these carve-outs go to the mega private equity funds.
Becker Private Equity & Business Podcast
Healthcare Private Equity Carveouts: Trends and Insights with Amber Walsh of McGuireWoods LLP 3-7-25
You see it in the middle market and you even see some lower middle markets But that becomes a little bit less common because they tend to be pretty expensive, which kind of leads me to my last point observations is some examples of these. So in the past year in services, which you know is where I kind of live and breathe, in traditional services, we saw KKR buy Eugene from Fresenius.
Becker Private Equity & Business Podcast
Healthcare Private Equity Carveouts: Trends and Insights with Amber Walsh of McGuireWoods LLP 3-7-25
and rolling UGEN, which was Fresenius' fertility platform, into KKR's existing IVI-RMA deal, and then Carlisle buying Baxter's dialysis unit and rebranding as Vantiv, and that was a nearly $4 billion deal. So they're not all that expensive, but they can be pretty high-dollar deals, particularly when it's a high-performing asset like Baxter's dialysis unit. Just very interesting.
Becker Private Equity & Business Podcast
Healthcare Private Equity Carveouts: Trends and Insights with Amber Walsh of McGuireWoods LLP 3-7-25
It's a whole other interesting area of private equity M&A activity that's not the more common sponsor to sponsor or founder to sponsor.
Becker Private Equity & Business Podcast
Healthcare Private Equity Carveouts: Trends and Insights with Amber Walsh of McGuireWoods LLP 3-7-25
Thank you, Scott.
Becker Private Equity & Business Podcast
Healthcare Private Equity Carveouts: Trends and Insights with Amber Walsh of McGuireWoods LLP 3-7-25
We're not talking about deals where it's first institutional capital, where you have a founder selling to a private equity sponsor, or it's a stress deal. What we're talking about and what I'm really interested in today is healthcare private equity carve-outs
Becker Private Equity & Business Podcast
Healthcare Private Equity Carveouts: Trends and Insights with Amber Walsh of McGuireWoods LLP 3-7-25
typically, most commonly from a very, very, very large cap mega healthcare company divesting one of its divisions or one of its assets to a private equity fund. And we really saw an uptick in that again in 2024, as everyone's kind of reporting and crunching the data from last year. And that's really been a steady uptick from 2010 in that particular area.