Holly Buckley
Appearances
Becker Private Equity & Business Podcast
Healthcare Private Equity Update with Holly Buckley of McGuireWoods LLP 4-9-25
But we're maybe seeing some reduction in competition around certain assets, just given some reluctance to invest. I think we're seeing a lot of investors looking for investments with little or no exposure to government reimbursement. I think there's just so much uncertainty right now in terms of government reimbursement that
Becker Private Equity & Business Podcast
Healthcare Private Equity Update with Holly Buckley of McGuireWoods LLP 4-9-25
Investors are looking for areas where they're either a degree removed or in a different sector. One area that may not be surprising to have a lot of discussion at KO is women's health.
Becker Private Equity & Business Podcast
Healthcare Private Equity Update with Holly Buckley of McGuireWoods LLP 4-9-25
It's an area that I think that folks view as having a lot of potential, but a lot of assets are still more at the VC size, but a lot of interest in assets around women's behavioral health, lactation, apps, menopause, just I think a lot of potential in this area.
Becker Private Equity & Business Podcast
Healthcare Private Equity Update with Holly Buckley of McGuireWoods LLP 4-9-25
and then med spa we've talked about that's still an area with a lot of opportunity infusion and there's still a big focus on value-based care and then in terms of ppm where we've seen a fair amount of pullback the themes really are that it needs to be ppm plus like just rolling up businesses is not enough there needs to be a strong angle in addition to that as well as the key focus on
Becker Private Equity & Business Podcast
Healthcare Private Equity Update with Holly Buckley of McGuireWoods LLP 4-9-25
on culture and vision. But let me pause there and see if there are questions on any of those.
Becker Private Equity & Business Podcast
Healthcare Private Equity Update with Holly Buckley of McGuireWoods LLP 4-9-25
Yeah, I mean, look, I think there's always a general great vibe when you get to a women's investor conference. I think it's just an area where there frankly is not enough female representation yet. And so anytime you get a bunch of women together who are passionate about healthcare investing, there's a great vibe and a great excitement about visiting.
Becker Private Equity & Business Podcast
Healthcare Private Equity Update with Holly Buckley of McGuireWoods LLP 4-9-25
But I think in terms of the market, I mean, I don't think anyone's excited about it. I think that there's a huge amount of trepidation and anxiety. I think that the current environment is one where No one quite knows what any day is going to bring and folks are watching their stock portfolio crater or wildly bounce around.
Becker Private Equity & Business Podcast
Healthcare Private Equity Update with Holly Buckley of McGuireWoods LLP 4-9-25
So I wouldn't say anyone's excited about the current environment on a kind of macro level, but great excitement about getting together and visiting and optimism that better things are to come.
Becker Private Equity & Business Podcast
Healthcare Private Equity Update with Holly Buckley of McGuireWoods LLP 4-9-25
Yeah, I just don't know, Scott. I mean, I think that up until a couple of weeks ago, there was a fair amount of optimism. I think In the last week, I think a lot of things have been thrown into uncertainty.
Becker Private Equity & Business Podcast
Healthcare Private Equity Update with Holly Buckley of McGuireWoods LLP 4-9-25
I can give some slightly more concrete updates on some trends on the federal level, but I think in terms of the deal environment, I think much remains uncertain until we get some clarity in terms of what the tariffs are going to look like in the macroeconomic environment. But I think on the federal level, there are certain things that we can actually comment on.
Becker Private Equity & Business Podcast
Healthcare Private Equity Update with Holly Buckley of McGuireWoods LLP 4-9-25
On March 11th, the Senate confirmed Dale Slater as Assistant Attorney General for the U.S. Department of Justice Antitrust Division. I think we are anticipating still an active antitrust enforcement this year, although there's going to be a difference in approach from the Lina Khan era.
Becker Private Equity & Business Podcast
Healthcare Private Equity Update with Holly Buckley of McGuireWoods LLP 4-9-25
But we're still expecting broad antitrust scrutiny across deals, wage fixing, no-poach agreements, information sharing, and pricing. And I think that we do not think we'll see a reversal on the new Hotspot Rodino filing requirements, which took effect in February. We think they're going to kind of be here to stay. We think there's going to be a ramp up of False Claims Act enforcement.
Becker Private Equity & Business Podcast
Healthcare Private Equity Update with Holly Buckley of McGuireWoods LLP 4-9-25
Thanks, Scott, and thanks for having me on. I'm actually coming at you live today from the KO 2025 Women's Healthcare Private Equity Summit here in Chicago. So I apologize if there's any background noise. So it's actually great to be at a conference right now and hear some of the discussion around what folks are seeing and how they're viewing the market.
Becker Private Equity & Business Podcast
Healthcare Private Equity Update with Holly Buckley of McGuireWoods LLP 4-9-25
The DOJ has signaled an aggressive stance on False Claims Act enforcement, which fits with the Trump administration's priorities of increasing government efficiency and rooting out waste, fraud and abuse. And so I think we'll see an aggressive enforcement climate. We are continuing to see a proliferation of executive orders addressing a wide range of healthcare issues.
Becker Private Equity & Business Podcast
Healthcare Private Equity Update with Holly Buckley of McGuireWoods LLP 4-9-25
We've been tracking them at the law firm and we're seeing executive orders around telehealth access and health equity, Medicare cost reduction, behavioral health infrastructure modernization, behavioral health access, as well as things like transgender care that kind of fit with the Trump agenda. and we expect to continue to see more executive orders coming out of the administration.
Becker Private Equity & Business Podcast
Healthcare Private Equity Update with Holly Buckley of McGuireWoods LLP 4-9-25
And then as far as Dr. Oz goes, he is the new CMS administrator. We are seeing a focus on Medicare Advantage and probably away from value-based care initiatives within traditional Medicare, which we were starting to see through the prior administration. So we think he'll really be focused on Medicare Advantage, and he's kind of pulling back some of the programs that were on traditional Medicare.
Becker Private Equity & Business Podcast
Healthcare Private Equity Update with Holly Buckley of McGuireWoods LLP 4-9-25
And so those are some of the things we know about on the federal level, and I think much remains kind of up in the air in terms of what will be coming next.
Becker Private Equity & Business Podcast
Healthcare Private Equity Update with Holly Buckley of McGuireWoods LLP 4-9-25
Yeah, we agree.
Becker Private Equity & Business Podcast
Healthcare Private Equity Update with Holly Buckley of McGuireWoods LLP 4-9-25
Yeah, thank you for that opportunity. We're super excited. As you said, May 14th and 15th in Chicago. Anyone's welcome to reach out to me if they have questions. We've got a packed agenda with kind of deep dive sessions on healthcare provider investments, pharma services, digital health, as well as management of portfolio companies.
Becker Private Equity & Business Podcast
Healthcare Private Equity Update with Holly Buckley of McGuireWoods LLP 4-9-25
We have a portfolio company boot camp on the 13th leading into the conference. It's a pre-conference event. And we have some great keynote panels, including Lance Armstrong. And we have a healthcare leadership panel on the 14th, as well as healthcare private equity and healthcare lending keynote panels as well. So the content is going to be great. The networking opportunities will be even better.
Becker Private Equity & Business Podcast
Healthcare Private Equity Update with Holly Buckley of McGuireWoods LLP 4-9-25
And so I have a few thoughts just from hot takes from the conference so far and then a few thoughts on the federal level. In terms of what we're seeing in the market, I mean, I think one interesting observation is that healthcare provider services investing is likely somewhat tariff resistant.
Becker Private Equity & Business Podcast
Healthcare Private Equity Update with Holly Buckley of McGuireWoods LLP 4-9-25
And we'd love to see folks who are interested attending and reach out to me at hbuckley at mcguirewoods.com if you have questions.
Becker Private Equity & Business Podcast
Healthcare Private Equity Update with Holly Buckley of McGuireWoods LLP 4-9-25
Thank you, Scott.
Becker Private Equity & Business Podcast
Healthcare Private Equity Update with Holly Buckley of McGuireWoods LLP 4-9-25
While I think the overall market conditions are going to have somewhat of an impact in terms of the specific sector, it may be a better sector to be in than some others that are going to be much more greatly impacted. I think, though, there are very strong headwinds and or strong headwinds in terms of the regulatory environment at both the federal and state level for different reasons.
Becker Private Equity & Business Podcast
Healthcare Private Equity Update with Holly Buckley of McGuireWoods LLP 4-9-25
The federal level, it's really the uncertainty of the new administration. And on the state level, it's really around the transaction notices, both notice and consent that we're seeing a proliferation of. And we've talked about a number of other times. I think one of the other big headwinds we're seeing a lot of discussion around is just continued staff shortages and labor market issues.
Becker Private Equity & Business Podcast
Semaglutide, Healthcare Transaction Laws, and Walgreens’ Take-Private Deal with Holly Buckley of McGuireWoods LLP 3-5-25
That's right. That's right. So because there was a shortage, the FDA kind of put the drug on a shortage list. It meant these compounders could do what they otherwise would not have been able to do. You're right. It was a leeway that they wouldn't normally have. And that leeway is now gone. And so it'll be interesting to see.
Becker Private Equity & Business Podcast
Semaglutide, Healthcare Transaction Laws, and Walgreens’ Take-Private Deal with Holly Buckley of McGuireWoods LLP 3-5-25
A lot of those companies are saying that they're going to pursue other opportunities. But there was kind of a huge market for them that it turned out, is pretty short-lived, right? A lot of them really proliferated in 2024 and now will likely have to do something different.
Becker Private Equity & Business Podcast
Semaglutide, Healthcare Transaction Laws, and Walgreens’ Take-Private Deal with Holly Buckley of McGuireWoods LLP 3-5-25
Yeah, so this is a continuation of something we've talked about a number of other times, and it is this, I'll use the word proliferation again, proliferation of states that are passing healthcare transaction notice laws. And last time we chatted, we talked about California and they had the big veto of the 3129 bill last year. They've come back this year with a couple of different bills.
Becker Private Equity & Business Podcast
Semaglutide, Healthcare Transaction Laws, and Walgreens’ Take-Private Deal with Holly Buckley of McGuireWoods LLP 3-5-25
And we chatted about that in some detail. But in addition, there are a number of other states that have come out with bills as well. So Indiana, which
Becker Private Equity & Business Podcast
Semaglutide, Healthcare Transaction Laws, and Walgreens’ Take-Private Deal with Holly Buckley of McGuireWoods LLP 3-5-25
which already has a bill that requires 90 days advance notice before certain healthcare transactions, has introduced a new bill which would amend the existing bill that would grant the AG approval of the transactions before it was just a notice requirement.
Becker Private Equity & Business Podcast
Semaglutide, Healthcare Transaction Laws, and Walgreens’ Take-Private Deal with Holly Buckley of McGuireWoods LLP 3-5-25
And that one is significantly more stringent in that the AG now can actually say no to transactions whereas before they were just kind of gathering information. New York is another one. The New York governor's 2526 budget proposal includes proposed changes that would expand the scope of the state's existing closure of material transactions law.
Becker Private Equity & Business Podcast
Semaglutide, Healthcare Transaction Laws, and Walgreens’ Take-Private Deal with Holly Buckley of McGuireWoods LLP 3-5-25
This would extend the pre-closing notice period from 30 to 60 days, require the New York Department of Health to conduct a preliminary review to assess whether a cost market impact review is needed. and could delay closing up to 180 days and require submission of annual reports detailing impact on cost, quality, access, health, equity, and competition.
Becker Private Equity & Business Podcast
Semaglutide, Healthcare Transaction Laws, and Walgreens’ Take-Private Deal with Holly Buckley of McGuireWoods LLP 3-5-25
So that's obviously a much more burdensome bill. If that is passed, it's expected to be approved by April 1st. And then Washington State also introduced a new bill, which is House Bill 1881, which would expand the scope of the state's existing healthcare material change notice requirements.
Becker Private Equity & Business Podcast
Semaglutide, Healthcare Transaction Laws, and Walgreens’ Take-Private Deal with Holly Buckley of McGuireWoods LLP 3-5-25
Yeah, Scott, thanks. And thanks as always for having me on. I have three topics to talk about today. The first one is on semaglutide, which is the ingredient used in diet drugs such as Wegovy and Zetbound. And the FDA determined at the end of last month, on February 21st, that there's no longer a shortage of semaglutide medications. Now, what this means is that it's come off the shortage list.
Becker Private Equity & Business Podcast
Semaglutide, Healthcare Transaction Laws, and Walgreens’ Take-Private Deal with Holly Buckley of McGuireWoods LLP 3-5-25
It would also extend the period from 60 to 90 days, would give the AG broad discretion over whether a specific transaction qualifies as material and requires submission and review by both the Washington Health Care Authority and Attorney General. So these laws are making deals certainly more difficult and costly. We're still not seeing deals necessarily be halted by these laws.
Becker Private Equity & Business Podcast
Semaglutide, Healthcare Transaction Laws, and Walgreens’ Take-Private Deal with Holly Buckley of McGuireWoods LLP 3-5-25
but it's definitely making the landscape more complicated, especially where you have companies transacting who do business in many, many states.
Becker Private Equity & Business Podcast
Semaglutide, Healthcare Transaction Laws, and Walgreens’ Take-Private Deal with Holly Buckley of McGuireWoods LLP 3-5-25
And then my final one, which I'm sure everyone has heard about, but I just think is interesting, is the, it sounds like very close and it may have been announced in the time I've been working this morning, the buyout of Walgreens, the take private, which would likely result in the company being split up into kind of the US retail, the kind of boots retail, which is kind of originated out of the UK, and then some other segments such as Village MD and other lines.
Becker Private Equity & Business Podcast
Semaglutide, Healthcare Transaction Laws, and Walgreens’ Take-Private Deal with Holly Buckley of McGuireWoods LLP 3-5-25
And so that's rumored to be a $10 billion transaction. I had read that I think, and I may get this slightly wrong, but in 2014, the company was maybe valued at $100 billion and has just lost an immense amount of that value over the past 11 years. But I think it's super interesting that Walgreens, which is such a household name, is likely to go private in the coming years.
Becker Private Equity & Business Podcast
Semaglutide, Healthcare Transaction Laws, and Walgreens’ Take-Private Deal with Holly Buckley of McGuireWoods LLP 3-5-25
Thank you.
Becker Private Equity & Business Podcast
Semaglutide, Healthcare Transaction Laws, and Walgreens’ Take-Private Deal with Holly Buckley of McGuireWoods LLP 3-5-25
And so compounders cannot compound that drug. And so all of these alternatives to agovian Zetbound that have kind of proliferated on the market that are compounded are no longer able to be made. And the FDA has said it will not take action against those compounders. until April for state-licensed pharmacy or physician compounders or May 22nd for outsourcing facilities that are 503B facilities.
Becker Private Equity & Business Podcast
Semaglutide, Healthcare Transaction Laws, and Walgreens’ Take-Private Deal with Holly Buckley of McGuireWoods LLP 3-5-25
But after that point, the FDA may go after them if they are still compounding semaglutide. And so we're also likely to see an increase in cease and desist letters from manufacturers, such as Eli Lilly and Novo Nordisk, who make SCOBY and ZetBound they may well start to go after more of the compounders if they continue to compound.
Becker Private Equity & Business Podcast
Staying Focused in Uncertain Times: Leadership Lessons from Holly Buckley of McGuireWoods LLP 4-15-25
And I think by taking hold of the things that we can control and within our own orbit, it can make you feel more grounded. So by that, I mean... your day-to-day, how do you execute on the tasks that you have in front of you, sit down, build lists, keep focused, and not let some of the bigger things that are happening just overwhelm.
Becker Private Equity & Business Podcast
Staying Focused in Uncertain Times: Leadership Lessons from Holly Buckley of McGuireWoods LLP 4-15-25
And I think in terms of the political side of things, for those people who are feeling just very rattled by a lot of the changes that are happening, I think the advice I heard that I really liked is, again, with picking something within your control, Pick a cause, pick a group that's doing things that help the thing that you're most concerned about and take some actual action yourself.
Becker Private Equity & Business Podcast
Staying Focused in Uncertain Times: Leadership Lessons from Holly Buckley of McGuireWoods LLP 4-15-25
And by doing these things, both in terms of your day-to-day, putting one foot in front of the other, as well as picking causes or groups that are supportive of the things that you care about, you can start to feel like you're regaining some of that control and feel like a normal person who's able to function again.
Becker Private Equity & Business Podcast
Staying Focused in Uncertain Times: Leadership Lessons from Holly Buckley of McGuireWoods LLP 4-15-25
So that's probably the best I have right now, but it is certainly a very tumultuous time that we're in, and I think a lot of people are really feeling that.
Becker Private Equity & Business Podcast
Staying Focused in Uncertain Times: Leadership Lessons from Holly Buckley of McGuireWoods LLP 4-15-25
I mean, I think it's the same thing, Scott. It's helping people focus on the things they can control. It's giving people some tangible things that they can actually execute on and encouraging them to center themselves. I mean, you don't tell clients how you need to center yourself.
Becker Private Equity & Business Podcast
Staying Focused in Uncertain Times: Leadership Lessons from Holly Buckley of McGuireWoods LLP 4-15-25
but you can help them with the things that they need help with and help them focus on their long-term business core strategy. Because I think for the most part, the core strategy is going to remain the same if you're in a sector that's not heavily impacted by some of the changes that are happening.
Becker Private Equity & Business Podcast
Staying Focused in Uncertain Times: Leadership Lessons from Holly Buckley of McGuireWoods LLP 4-15-25
So one of the things I was actually going to chat about with you today is I wanted to get your views on some of the tariff impact on healthcare services, for example, But one take on healthcare services is in some ways it is a better area than others with respect to the tariffs in that it is domestic. There is not a heavy focus on supply chain issues.
Becker Private Equity & Business Podcast
Staying Focused in Uncertain Times: Leadership Lessons from Holly Buckley of McGuireWoods LLP 4-15-25
Sounds great, Scott.
Becker Private Equity & Business Podcast
Staying Focused in Uncertain Times: Leadership Lessons from Holly Buckley of McGuireWoods LLP 4-15-25
A lot of the clients we work with are working on tech enabled platforms, which are less impacted by the tariffs. And so maybe the sector is more resilient and less reliant on some of the global trends that are happening.
Becker Private Equity & Business Podcast
Staying Focused in Uncertain Times: Leadership Lessons from Holly Buckley of McGuireWoods LLP 4-15-25
And so there's not necessarily a need for a major strategy refocus, whereas other businesses may need more help with a global strategy refocus, but a lot of the businesses we work with don't. So it's continuing to help them focus and hone in on the core business strategy and execution. They have their own problems with workforce and the things that we're dealing with.
Becker Private Equity & Business Podcast
Staying Focused in Uncertain Times: Leadership Lessons from Holly Buckley of McGuireWoods LLP 4-15-25
A lot of it is just, you know, the big, broad dialogues of helping people hone in on what they need to be doing and what they need to focus on, what does and doesn't need to change, and then just doubling down on execution. So, I mean, the best thing we can do is be great advisors, be a consistent, and help people work through this tumultuous time.
Becker Private Equity & Business Podcast
Staying Focused in Uncertain Times: Leadership Lessons from Holly Buckley of McGuireWoods LLP 4-15-25
I think that's right. I mean, I think the Medicaid cuts are another area that is super interesting and we're watching and I think don't fully understand yet. I think the Republicans have passed their budget resolution and They need to cut $880 billion in costs through 2034, and it's got to come from somewhere.
Becker Private Equity & Business Podcast
Staying Focused in Uncertain Times: Leadership Lessons from Holly Buckley of McGuireWoods LLP 4-15-25
And I think given where they have jurisdiction, we think a lot of it will come from Medicaid. I think we need to wait and see a little bit in terms of where that comes from. But it's interesting because a lot of the areas that could be very impacted by Medicaid cuts are also the areas that still... reflects really good investment opportunities just based on other dynamics.
Becker Private Equity & Business Podcast
Staying Focused in Uncertain Times: Leadership Lessons from Holly Buckley of McGuireWoods LLP 4-15-25
So I think we just don't know what the areas such as home health, substance abuse, mental health providers. We need to know more before we can really say what the impact is going to be. But thank you for your kind comments too. They are appreciated. And I think some of it is just not looking at the stock market.
Becker Private Equity & Business Podcast
Staying Focused in Uncertain Times: Leadership Lessons from Holly Buckley of McGuireWoods LLP 4-15-25
100%. 100%.
Becker Private Equity & Business Podcast
Staying Focused in Uncertain Times: Leadership Lessons from Holly Buckley of McGuireWoods LLP 4-15-25
Thanks, Scott. I mean, I think it's an excellent question. And I certainly have been feeling the impact of the the greater world on my day to day. And I think it's hard both personally and as a leader to kind of put things in a place where you're able to continue to function.
Becker Private Equity & Business Podcast
Staying Focused in Uncertain Times: Leadership Lessons from Holly Buckley of McGuireWoods LLP 4-15-25
Thank you, Scott.
Becker Private Equity & Business Podcast
Staying Focused in Uncertain Times: Leadership Lessons from Holly Buckley of McGuireWoods LLP 4-15-25
But I think I heard some good advice on a podcast and I saw the same advice repeated by my partner, Tim Fry, just last week in an email. And I think the best advice I could give and try and give to my team is to control the things that you can control. And I think a lot of the difficulty with what is happening right now is that everything does feel so crazily out of control and unpredictable.
Becker Private Equity & Business Podcast
2025 Healthcare Private Equity Deal Trends 2-11-25
So my prediction is there's going to be less, but not a lot less. I think Lena Kahn was, you know, an outlier. She was a lot more aggressive than we've seen in a very long time out of the FTC. But I think the FTC's priorities are somewhat bipartisan. And I think that there's still going to be a lot of desire to put pressure on private equity, private equity investments.
Becker Private Equity & Business Podcast
2025 Healthcare Private Equity Deal Trends 2-11-25
And so I think we're going to see an easier M&A climate, but I don't think it's going to be a reversion to the pre-lien account days. I think it's still going to be tough. I think there's also a good chance, a very good chance that the new HSR rules stay. And so there's a new HSR rule that's kind of floating right now in terms of we're not quite sure what's going to happen with it.
Becker Private Equity & Business Podcast
2025 Healthcare Private Equity Deal Trends 2-11-25
But I think our intelligence is that it's likely to proceed as is. And the new HSR rule puts about four times the burden on respondents than the prior one. So there's a lot more information needed and a much higher burden and expense related to it. And so, again, I think we're going to see a slight increase a slightly easier climate, but it's not going to be back to the old days.
Becker Private Equity & Business Podcast
2025 Healthcare Private Equity Deal Trends 2-11-25
You know, I'll say there's an area I'm focused on, but I won't say I'm excited about it. And that's kind of the distress deals that we were just speaking about. I think it would be improper to say I was excited about it.
Becker Private Equity & Business Podcast
2025 Healthcare Private Equity Deal Trends 2-11-25
There's an analytical excitement about it in terms of they're an interesting type of transaction to work on as an attorney, but it's never exciting to see what's happened to some of these businesses that folks obviously had a lot of hope behind and put a lot of energy into. But I think there's also a lot of opportunity in the distressed space as some platforms have run into issues as opportunities
Becker Private Equity & Business Podcast
2025 Healthcare Private Equity Deal Trends 2-11-25
for other acquirers to potentially bring them in to see some synergies with existing platforms that they have. We just worked on the CareMax transaction, which closed in the last week, which was a very interesting transaction. And I think there's going to be a fair amount of activity
Becker Private Equity & Business Podcast
2025 Healthcare Private Equity Deal Trends 2-11-25
Thanks, Scott. Thanks very much for having me here today. Holly Buckley, I chair the healthcare practice at McGuire Woods. My personal practice is around healthcare M&A, healthcare regulatory work, for both private equity funds, private equity-backed portfolio companies, as well as traditional healthcare participants.
Becker Private Equity & Business Podcast
2025 Healthcare Private Equity Deal Trends 2-11-25
As a firm, we have one of the top healthcare groups in the country, as well as healthcare private equity, kind of lower market, middle market. And we also have the top independent sponsor and emerging manager legal practices. And just a very quick plug for our 21st Healthcare Private Equity Conference in May, the 14th and 15th at the RITC. in Chicago. It's going to be a great event.
Becker Private Equity & Business Podcast
2025 Healthcare Private Equity Deal Trends 2-11-25
We have Lance Armstrong as our keynote speaker, and you can find details at healthcareprivateequity.com.
Becker Private Equity & Business Podcast
2025 Healthcare Private Equity Deal Trends 2-11-25
Great. So a couple of things that jump out, and this year and last year were very different than prior years in that we had this quick emergence of state-level pre-transaction filing requirements.
Becker Private Equity & Business Podcast
2025 Healthcare Private Equity Deal Trends 2-11-25
So while you'd have the federal antitrust filing for transactions above a certain size, a number of states came out with laws that said if you're doing a transaction of either any size or any size above a certain pretty low threshold that involves healthcare or healthcare private equity, you need to file with the state before that transaction closes and have some level of
Becker Private Equity & Business Podcast
2025 Healthcare Private Equity Deal Trends 2-11-25
review over that transaction. So some of the states with those laws are Washington, Oregon, California, Nevada, New Mexico, Minnesota, Illinois, Indiana, New York, Connecticut, and Massachusetts. And just in the last few weeks, at least six state legislatures have introduced bills to curtail or demand more information about healthcare transactions. So this is just a very rapidly moving area.
Becker Private Equity & Business Podcast
2025 Healthcare Private Equity Deal Trends 2-11-25
And for anyone investing in health care businesses, it's critical to be on top of these because they can trip you up and they can also create slowdowns in your closing timelines.
Becker Private Equity & Business Podcast
2025 Healthcare Private Equity Deal Trends 2-11-25
Yeah, so some states are really, really tricky. So, for example, Oregon, I think, is maybe 180 day pre-closing notice. So there's certainly a lot of investors that will stay away from Oregon at this point. And the same is true of some other states. There are other states that, while they have requirements, the timelines are maybe not super long. They're not actually preventing deals from closing.
Becker Private Equity & Business Podcast
2025 Healthcare Private Equity Deal Trends 2-11-25
It's more a matter of an additional step in the process, but we're not seeing regulators actually try to thwart deals. But I think it is creating some reluctance in certain states. You wouldn't be surprised that California is one of them, right? It's a difficult state, and And it's always been difficult. And some investors have an appetite and others don't.
Becker Private Equity & Business Podcast
2025 Healthcare Private Equity Deal Trends 2-11-25
So we will see this factor into decisions around where to invest and who's willing to invest.
Becker Private Equity & Business Podcast
2025 Healthcare Private Equity Deal Trends 2-11-25
Yeah, I think one other one I would touch on is we're seeing a lot of excitement and interest in post-acute care and kind of the movement to health care at home. We saw it last year too, and it's been around. I mean, this isn't a new thing, but we are seeing a lot of excitement and energy around it.
Becker Private Equity & Business Podcast
2025 Healthcare Private Equity Deal Trends 2-11-25
And I think this would include things like home infusion, hospice, home health, skilled and unskilled. And I think with the new administration, we're likely to see less regulatory burdens. and oversight, which I think will help continue to accelerate investment in this space.
Becker Private Equity & Business Podcast
2025 Healthcare Private Equity Deal Trends 2-11-25
So for example, maybe there'll be a repeal of the 80-20 rule, which requires 80% of Medicaid payments going to direct care workers. Also with maybe more flexibility around workers and more movement towards Medicare Advantage, we think that this area will continue to be pretty hot and we'll continue to see more transaction volume this year.
Becker Private Equity & Business Podcast
Holly Buckley on Bad Career Advice and Breaking the Mold in Big Law 6-3-25
He judged me based on his perception of what he felt big law was and what government was and what he thought I was capable of or fit for. And it was a surprise to me that he would have made that pronouncement. And he apparently was wrong because I'm pretty, pretty far in on big law and have done relatively well for myself. And I think
Becker Private Equity & Business Podcast
Holly Buckley on Bad Career Advice and Breaking the Mold in Big Law 6-3-25
Maybe the lesson from that is don't let others project onto you their impressions and go with your own gut and make your own decisions and freely try to decide the advice of people.
Becker Private Equity & Business Podcast
Holly Buckley on Bad Career Advice and Breaking the Mold in Big Law 6-3-25
Sure. I don't think the advice was meant in a good way. And I was taken aback and it was fuel for the fire. In hindsight, I think the advice was given based on this person's perception of what a really good big law junior associate looked like. And I don't know that that was necessarily me. And I did do relatively well as a junior associate.
Becker Private Equity & Business Podcast
Holly Buckley on Bad Career Advice and Breaking the Mold in Big Law 6-3-25
I think he perceived that I was not someone who would kind of quickly fall in line, put my head down and just do exactly what I was told. And he, there was a certain kind of group of associates or of law students that this particular person would tend to support more. And they tended to be people who are much kind of quieter and fall in line.
Becker Private Equity & Business Podcast
Holly Buckley on Bad Career Advice and Breaking the Mold in Big Law 6-3-25
And I didn't really fit the mold that he thought you needed to be successful. Now, I think that the world has changed a lot. And I think we now expect more junior folks to be bigger thinkers and to push us as more senior people. And so I think his view was maybe a little antiquated. I don't think it was ill-intentioned when he said it.
Becker Private Equity & Business Podcast
Holly Buckley on Bad Career Advice and Breaking the Mold in Big Law 6-3-25
I think it was his genuine belief that I wouldn't necessarily do well.
Becker Private Equity & Business Podcast
Holly Buckley on Bad Career Advice and Breaking the Mold in Big Law 6-3-25
Oh, uh, it's funny. Cause I think that the two things that first, uh, came to mind are probably not very profound or helpful to, uh, a broader audience, but I will share them nonetheless, just because they're the first thing that came to mind and you took me by surprise with the topic. But I think maybe there's a broader lesson that can be pulled out of them.
Becker Private Equity & Business Podcast
Holly Buckley on Bad Career Advice and Breaking the Mold in Big Law 6-3-25
I think the other piece of horrible advice that I hear really – somewhat frequently, both directly and indirectly for more junior people is around women and their dress codes and different more senior women's perception of how more junior women should dress in the workplace. And I think these comments in general are very misguided. And I think are generally poorly received.
Becker Private Equity & Business Podcast
Holly Buckley on Bad Career Advice and Breaking the Mold in Big Law 6-3-25
So there's one particular line of this around how more junior women should have some very expensive pieces in their closet, a very expensive suit, say an Armani suit, very expensive shoes, and the message that that sends. And I think those, I mean, this is a totally different topic than kind of the first one, but it was, again, the second thing that came to mind
Becker Private Equity & Business Podcast
Holly Buckley on Bad Career Advice and Breaking the Mold in Big Law 6-3-25
And every time I hear these comments, I'm always just shocked that someone would make them. And there is not a scenario where they have been well-received. And so I think in general, women need to probably let other women be and less us.
Becker Private Equity & Business Podcast
Holly Buckley on Bad Career Advice and Breaking the Mold in Big Law 6-3-25
And in general, remember that people come from different levels of wealth and recommending people buy Armani suits and very expensive shoes may not resonate too well with others.
Becker Private Equity & Business Podcast
Holly Buckley on Bad Career Advice and Breaking the Mold in Big Law 6-3-25
Thank you, Scott. And massive congratulations to you and Chanel. That is just tremendous. And thanks for the words for having me on.
Becker Private Equity & Business Podcast
Holly Buckley on Bad Career Advice and Breaking the Mold in Big Law 6-3-25
So the first was when I was in law school and I was looking for work after law school. And I'm a first generation lawyer in my family. And I didn't really even know what a law firm was. When I went to law school, I kind of knew I was doing healthcare transactions and didn't really know the venues to do that.
Becker Private Equity & Business Podcast
Holly Buckley on Bad Career Advice and Breaking the Mold in Big Law 6-3-25
And there was a particular professor that had a pretty defined view of what a big firm lawyer looked like. And he told me that he did not think that I was big law firm material and that maybe I should seek a job in government, which is obviously a great place to work also and has a lot of opportunities.
Becker Private Equity & Business Podcast
Shifts in FTC Leadership, Big Tech Dynamics, and the Healthcare Deal Market: Insights from Holly Buckley of McGuireWoods LLP 1-23-25
But I think some sources have reported that there's likely to be a continued focus and scrutiny on the dominance of the big tech platforms, which I think is really interesting in light of some of the alliances that Trump's been forging with some of the big tech leaders that may be a connection there.
Becker Private Equity & Business Podcast
Shifts in FTC Leadership, Big Tech Dynamics, and the Healthcare Deal Market: Insights from Holly Buckley of McGuireWoods LLP 1-23-25
And it'll be interesting to see how much scrutiny those big tech companies do continue to get from the FTC in light of some of the dynamics in Washington right now.
Becker Private Equity & Business Podcast
Shifts in FTC Leadership, Big Tech Dynamics, and the Healthcare Deal Market: Insights from Holly Buckley of McGuireWoods LLP 1-23-25
Yeah, no, I think it is very interesting. And I listened to a podcast the other day. It was a New York Times one. And there was a discussion with Mark Anderson, who was kind of discussing these dynamics and kind of the switch. And it...
Becker Private Equity & Business Podcast
Shifts in FTC Leadership, Big Tech Dynamics, and the Healthcare Deal Market: Insights from Holly Buckley of McGuireWoods LLP 1-23-25
He described it much more as something that had happened over time, over kind of the last 10 years with kind of the left and its impact on tech companies and kind of anti-business perspectives and less of an old Trump one. And so now everyone is kind of flip-flopping over.
Becker Private Equity & Business Podcast
Shifts in FTC Leadership, Big Tech Dynamics, and the Healthcare Deal Market: Insights from Holly Buckley of McGuireWoods LLP 1-23-25
It was described very differently, but I do think it's an interesting dynamic where you had Silicon Valley, which was a very... um reliably left-leaning constituency and now we are seeing a lot of silicon valley leadership very much um flipping to the right and um very uh vocally and um without any kind of hesitation seemingly, flipping to the right and cozying up with Trump.
Becker Private Equity & Business Podcast
Shifts in FTC Leadership, Big Tech Dynamics, and the Healthcare Deal Market: Insights from Holly Buckley of McGuireWoods LLP 1-23-25
I mean, the whole thing is fascinating and is probably the most, I guess, forward flip-flop that we've seen in terms of a group like that.
Becker Private Equity & Business Podcast
Shifts in FTC Leadership, Big Tech Dynamics, and the Healthcare Deal Market: Insights from Holly Buckley of McGuireWoods LLP 1-23-25
I mean, I don't think that the non-compete effort is going to be back at the federal level. I think that'll stay with the states. It's my personal belief. I just don't think that it's going to come back at the federal level. And I think that Notwithstanding that, I think there's been a permanent shift of kind of anti-non-compete.
Becker Private Equity & Business Podcast
Shifts in FTC Leadership, Big Tech Dynamics, and the Healthcare Deal Market: Insights from Holly Buckley of McGuireWoods LLP 1-23-25
It was already the trend, but I think with the federal effort, it's further kind of weakened non-competes. And I think they will continue to be eroded at the state level, especially for lower income, but also just in general, the employment-based non-compete, I think, will continue to be eroded. I think in terms of AI, we've heard some initial statements from
Becker Private Equity & Business Podcast
Shifts in FTC Leadership, Big Tech Dynamics, and the Healthcare Deal Market: Insights from Holly Buckley of McGuireWoods LLP 1-23-25
on the federal level, on the Republican side, that there's going to be less regulation of AI than there would have been under the Biden administration, where I think there was certainly going to be a much stronger effort to have federal regulation. And it was you know, under the guise of national security. But I think there was a much stronger fear of AI on the Democrat side.
Becker Private Equity & Business Podcast
Shifts in FTC Leadership, Big Tech Dynamics, and the Healthcare Deal Market: Insights from Holly Buckley of McGuireWoods LLP 1-23-25
And I think on the Republican side, I think we'll see less regulation there. I think on merger and acquisitions, I think we're going to see a move away from the much tougher regulation of M&A. And I think part of the sell for the business community on a Trump administration is the kind of more pro-business, pro-M&A climate that's been promised here.
Becker Private Equity & Business Podcast
Shifts in FTC Leadership, Big Tech Dynamics, and the Healthcare Deal Market: Insights from Holly Buckley of McGuireWoods LLP 1-23-25
So I do think we're going to see a rolling back of Lena Khan's agenda on many fronts. I'm probably most curious on the big tech front, just given the initial statements from Andrew Ferguson or not statements, but the source is reporting that Andrew Ferguson was still going to continue the scrutiny on big tech, but such a strong big tech presence in the Trump orbit.
Becker Private Equity & Business Podcast
Shifts in FTC Leadership, Big Tech Dynamics, and the Healthcare Deal Market: Insights from Holly Buckley of McGuireWoods LLP 1-23-25
I'm very curious to see what happens there.
Becker Private Equity & Business Podcast
Shifts in FTC Leadership, Big Tech Dynamics, and the Healthcare Deal Market: Insights from Holly Buckley of McGuireWoods LLP 1-23-25
Thanks for letting me do that. Next week, we're going to be in Dallas for a healthcare private equity pop-up event on January 29th. Chris Kersey from Havencrest Capital, who's just a fascinating guy, is going to be talking with Tim Fry, my partner, about deal trends and macroeconomic trends for 2025. We still have some space left there. We've got 60 plus folks who are going to be joining us.
Becker Private Equity & Business Podcast
Shifts in FTC Leadership, Big Tech Dynamics, and the Healthcare Deal Market: Insights from Holly Buckley of McGuireWoods LLP 1-23-25
Hey Scott, thanks as always for having me on. Holly Buckley, I chair the healthcare group at McGuire Woods, spend a fair amount of my time working in private equity transactions as well as general provider advising and transactional work. So a pleasure to be on. And I've been trying to keep my eye on what's happening at the FTC.
Becker Private Equity & Business Podcast
Shifts in FTC Leadership, Big Tech Dynamics, and the Healthcare Deal Market: Insights from Holly Buckley of McGuireWoods LLP 1-23-25
The goal of these events is to do a little bit of content, a little bit of discussion, but then really just a heavy focus networking event. And that's in the evening on January 29th next week. We still have some space left. You're welcome to reach out to me on LinkedIn. or email me at hbuckley at mcguirewoods.com if you'd like to attend and I'll get you the registration information.
Becker Private Equity & Business Podcast
Shifts in FTC Leadership, Big Tech Dynamics, and the Healthcare Deal Market: Insights from Holly Buckley of McGuireWoods LLP 1-23-25
And then on May 14th and 15th in Chicago, we have our annual healthcare private equity meeting at the Ritz. We're really excited for the agenda. We've really broadened out the agenda this year to have a much heavier focus on pharma services, healthcare tech, as well as our traditional focus on provider services. and kind of deal trends. And so it's going to be a great agenda.
Becker Private Equity & Business Podcast
Shifts in FTC Leadership, Big Tech Dynamics, and the Healthcare Deal Market: Insights from Holly Buckley of McGuireWoods LLP 1-23-25
I would love to see your registrations open again. You can email me or just go straight to the registration page on the McGuire Woods website. But it's going to be, I think, our best ever event. So definitely reach out if I can answer any questions.
Becker Private Equity & Business Podcast
Shifts in FTC Leadership, Big Tech Dynamics, and the Healthcare Deal Market: Insights from Holly Buckley of McGuireWoods LLP 1-23-25
He was also the former chairman of the board of Johns Hopkins Medicine. So just very accomplished guy. And we were thrilled to get him as a speaker and someone to share thoughts on what's going on. He's a very plugged in, very smart guy. So super excited about that.
Becker Private Equity & Business Podcast
Shifts in FTC Leadership, Big Tech Dynamics, and the Healthcare Deal Market: Insights from Holly Buckley of McGuireWoods LLP 1-23-25
Yeah, so I've got to first of all credit Rebecca Springer, who is formerly with Pitchberg and now is with Bailey and Company, who just does outstanding industry reports. And so I was looking at her post JP Morgan report and would credit her with this because I think she does a very nice job of putting things together.
Becker Private Equity & Business Podcast
Shifts in FTC Leadership, Big Tech Dynamics, and the Healthcare Deal Market: Insights from Holly Buckley of McGuireWoods LLP 1-23-25
And I'm more or less just going to crib some of some of her feedback from JP Morgan that we're also hearing in chatter. So Overall, I think we're all looking at a more active deal market this year than last year, although I'm not sure that we're necessarily going to see anything gangbusters, but I think we're expecting an upward trajectory in volume.
Becker Private Equity & Business Podcast
Shifts in FTC Leadership, Big Tech Dynamics, and the Healthcare Deal Market: Insights from Holly Buckley of McGuireWoods LLP 1-23-25
Some of her observations are that companies are really growing into the multiples they traded at in 2021 and are ready to transact.
Becker Private Equity & Business Podcast
Shifts in FTC Leadership, Big Tech Dynamics, and the Healthcare Deal Market: Insights from Holly Buckley of McGuireWoods LLP 1-23-25
And I think some sponsors who anticipated higher pricing are ready to kind of capitulate somewhat and accept a slightly lower multiple and are ready to trade because it's really just time to move some of those older vintage companies out of the portfolio and kind of move on for a respectable transaction.
Becker Private Equity & Business Podcast
Shifts in FTC Leadership, Big Tech Dynamics, and the Healthcare Deal Market: Insights from Holly Buckley of McGuireWoods LLP 1-23-25
She did know also that the number of processes that were launched at JP Morgan was not particularly high, but overall pitch activity is up. And then finally, just in the growth stage technology ecosystem, many lower quality companies traded or folded over the past year. And as a result, the quality of companies that are coming to market are up on average.
Becker Private Equity & Business Podcast
Shifts in FTC Leadership, Big Tech Dynamics, and the Healthcare Deal Market: Insights from Holly Buckley of McGuireWoods LLP 1-23-25
It's been a really interesting past few years with Lena Khan at the helm. The FTC has become much more aggressive and some may say activist. And a big focus of many heading into this election was a focus on on Lina Khan and whether she would still be in with a new administration or even if Kamala had won.
Becker Private Equity & Business Podcast
Shifts in FTC Leadership, Big Tech Dynamics, and the Healthcare Deal Market: Insights from Holly Buckley of McGuireWoods LLP 1-23-25
So expecting some good quality transactions in the healthcare tech space.
Becker Private Equity & Business Podcast
Shifts in FTC Leadership, Big Tech Dynamics, and the Healthcare Deal Market: Insights from Holly Buckley of McGuireWoods LLP 1-23-25
um and then of course some some ai announcements and some ai activity expected this year as well so overall we are excited cautiously optimistic and somewhat excited for the year and hoping for a a good year of deal making no absolutely fasting so so a lot going on out there big changes at the ftc um yeah and fasting because lena khan's gonna go down as a fasting person to watch
Becker Private Equity & Business Podcast
Shifts in FTC Leadership, Big Tech Dynamics, and the Healthcare Deal Market: Insights from Holly Buckley of McGuireWoods LLP 1-23-25
And with Trump coming in, Lina Khan is out, and Andrew Ferguson, who is a commissioner at the FTC, is the new head of the FTC. And there's also now a Republican majority on the commission. And so there's a lot of eyes in terms of what's going to be happening as we go forward. And we don't really know yet.
Becker Private Equity & Business Podcast
Healthcare PE Trends: Innovation, Investment Shifts & Market Outlook with Holly Buckley of McGuireWoods LLP 5-22-25
And there's a real focus on things like patient outcomes, access to care, and I mean, these have always been important themes, but the investment VCs are very much focused on tapping into those themes from an IT perspective, AI perspective, and how do we really solve problems in light of the fact that generalized growth is somewhat harder to come by.
Becker Private Equity & Business Podcast
Healthcare PE Trends: Innovation, Investment Shifts & Market Outlook with Holly Buckley of McGuireWoods LLP 5-22-25
I think from a lending perspective, similar to the investment side, there's anticipated to be an uptick in deal volume the second half of the year. The first half of the year has been slower, but really competitive pricing and aggressive terms are becoming more prevalent, especially in the middle market. And the availability of capital is high, which intensifies competition for quality deals.
Becker Private Equity & Business Podcast
Healthcare PE Trends: Innovation, Investment Shifts & Market Outlook with Holly Buckley of McGuireWoods LLP 5-22-25
So let me pause there for a second and we can talk about maybe some of the more specific investment trends.
Becker Private Equity & Business Podcast
Healthcare PE Trends: Innovation, Investment Shifts & Market Outlook with Holly Buckley of McGuireWoods LLP 5-22-25
I don't know that it's going to be floodgates as much as somewhat of an opening. I think there's still a lot of trepidation, but as we continually talk about, there's so much gray powder. And a lot of funds are out there fundraising. So there's going to be even more. So deals are happening and there will be more deals happening. But we're seeing deals happening in different spaces.
Becker Private Equity & Business Podcast
Healthcare PE Trends: Innovation, Investment Shifts & Market Outlook with Holly Buckley of McGuireWoods LLP 5-22-25
So a lot of deals in IT companies and companies looking to support the provider services businesses, but less in the actual provider services businesses. But then we're seeing more activity in certain sub-segments.
Becker Private Equity & Business Podcast
Healthcare PE Trends: Innovation, Investment Shifts & Market Outlook with Holly Buckley of McGuireWoods LLP 5-22-25
So we're still seeing a fair amount of interest in behavioral health, but it's not going to be just kind of a generic, not as much in just kind of generic provider services, but maybe more in telemed or tech-enabled platforms that are still delivering care, but maybe have another angle.
Becker Private Equity & Business Podcast
Healthcare PE Trends: Innovation, Investment Shifts & Market Outlook with Holly Buckley of McGuireWoods LLP 5-22-25
We're weirdly seeing, I don't know if it's weirdly or not, but continued activity in a resurgence of activity in DSOs, dental support organizations, which is just, that was kind of one of the first big waves kind of 10, 15 years ago. And it just kind of continues due to the massive market and the continued fragmentation.
Becker Private Equity & Business Podcast
Healthcare PE Trends: Innovation, Investment Shifts & Market Outlook with Holly Buckley of McGuireWoods LLP 5-22-25
And then we're also seeing investments in wellness services, but we're seeing, for example, wellness, med spa, longevity medicine, and kind of businesses like that starting to grow more. And then we're also seeing a lot in life sciences and pharma services.
Becker Private Equity & Business Podcast
Healthcare PE Trends: Innovation, Investment Shifts & Market Outlook with Holly Buckley of McGuireWoods LLP 5-22-25
Yeah, happy to do so. And it was a really fun, energizing few days. There's a lot of content there and still processing some of it. I had the privilege of interviewing Lance Armstrong, which was really fun. And he was a very interesting guy and had the entire room very much captivated.
Becker Private Equity & Business Podcast
Healthcare PE Trends: Innovation, Investment Shifts & Market Outlook with Holly Buckley of McGuireWoods LLP 5-22-25
So I don't know if it's going to be floodgates, but I think we will see growth in healthcare private equity deals through the end of the year, but not a massive amount, but some increase from where we're at right now.
Becker Private Equity & Business Podcast
Healthcare PE Trends: Innovation, Investment Shifts & Market Outlook with Holly Buckley of McGuireWoods LLP 5-22-25
Yeah, I mean, I think behavioral health still. I think one of the really interesting things that was a surprise to me was an interest in Medicaid-heavy businesses, which I thought were going to be somewhat DOA in light of the proposed Medicaid cuts that are going through the federal budget process right now. But there was a fair amount of
Becker Private Equity & Business Podcast
Healthcare PE Trends: Innovation, Investment Shifts & Market Outlook with Holly Buckley of McGuireWoods LLP 5-22-25
I'd say excitement around the possibilities of investing in Medicaid-focused businesses that were involved in doing those better. And so I think a lot of folks saw opportunity with that. So for example, if the work requirements become a much bigger factor, there's potentially opportunities for funds looking to invest in how to better facilitate the work requirements.
Becker Private Equity & Business Podcast
Healthcare PE Trends: Innovation, Investment Shifts & Market Outlook with Holly Buckley of McGuireWoods LLP 5-22-25
And I think just Medicaid being so big and so important, but with the federal government so focused on it, I think we are going to see a fair amount of focus there. I think the other big provider area that we continue to see really big interest in is infusion. I think with the growing significance of specialty medicine and individualized medicine and
Becker Private Equity & Business Podcast
Healthcare PE Trends: Innovation, Investment Shifts & Market Outlook with Holly Buckley of McGuireWoods LLP 5-22-25
in the push to get healthcare out of more expensive venues and into the home and more affordable outpatient venues, infusion remains really high on the interest list for a lot of firms.
Becker Private Equity & Business Podcast
Healthcare PE Trends: Innovation, Investment Shifts & Market Outlook with Holly Buckley of McGuireWoods LLP 5-22-25
Yeah, I'd say life sciences and pharma services deals are still of really big interest. So clinical trials, contract manufacturing, and things like that. But also looking at automation in the pharma services space and the use of AI in pharma services was something we heard a fair amount of discussion around.
Becker Private Equity & Business Podcast
Healthcare PE Trends: Innovation, Investment Shifts & Market Outlook with Holly Buckley of McGuireWoods LLP 5-22-25
So AI's role in clinical trial design, drug discovery, decentralized trial management, as well as just kind of automation around the entire pharma services spectrum. So around things like the compliance function. So I think we'll continue to see a lot of interest there.
Becker Private Equity & Business Podcast
Healthcare PE Trends: Innovation, Investment Shifts & Market Outlook with Holly Buckley of McGuireWoods LLP 5-22-25
And then a lot on the digital health side, like how can we automate different parts of the healthcare cycle, as well as kind of the integration with payers. So again, just less on the direct provider services, provision of care side, and more on the support services around the delivery of care.
Becker Private Equity & Business Podcast
Healthcare PE Trends: Innovation, Investment Shifts & Market Outlook with Holly Buckley of McGuireWoods LLP 5-22-25
But in terms of the actual substance around healthcare, private equity, and investing and lending, a few core thoughts. I'd say... In terms of the overall market outlook, I would frame it as cautious optimism amid regulatory and economic headwinds.
Becker Private Equity & Business Podcast
Healthcare PE Trends: Innovation, Investment Shifts & Market Outlook with Holly Buckley of McGuireWoods LLP 5-22-25
Yeah, and I mean, I think, Scott, timing is everything. I'd love to take credit for a great timed conference, but I think had the conference been two months earlier when all the tariff discussions started, I think the mood would have been very different. And I think with somewhat of a pullback on the tariff discussion and And the stock market somewhat rebounding to almost normal levels.
Becker Private Equity & Business Podcast
Healthcare PE Trends: Innovation, Investment Shifts & Market Outlook with Holly Buckley of McGuireWoods LLP 5-22-25
I think there was a lot more optimism and a much better vibe than there would have been if the conference had been two months earlier. So we were lucky with the timing there in terms of just the energy and the vibe. But I think what I'm really focused on was that we had a lot of just great conversations with folks about what they're looking at and kind of ways that we can help and connect people.
Becker Private Equity & Business Podcast
Healthcare PE Trends: Innovation, Investment Shifts & Market Outlook with Holly Buckley of McGuireWoods LLP 5-22-25
And so we're really focused on that. and then hopefully just getting into a good deal cycle for the next three, six, 12 month time period. So really just looking to figure out how we can add value for our clients and our friends in the market as they're continuing to look for good investments and execute on them.
Becker Private Equity & Business Podcast
Healthcare PE Trends: Innovation, Investment Shifts & Market Outlook with Holly Buckley of McGuireWoods LLP 5-22-25
You know, I just, I want to thank anyone that was listening today that was there. Thank you. I had one or two folks come up to me and say that they enjoy listening to your podcast, Scott, and that they have listened to some of our discussions. And so I'm happy that those people are out there. It's always fun to hear. And I think there's a few events coming up we'd love to make folks aware of.
Becker Private Equity & Business Podcast
Healthcare PE Trends: Innovation, Investment Shifts & Market Outlook with Holly Buckley of McGuireWoods LLP 5-22-25
We're going to be in New York June 11th and 12th for a New York and then Connecticut healthcare private equity pop-up meetings. each of those spots on those dates. If anyone's interested in those, feel free to reach out. And then we will have our Healthcare Growth and Operations Conference in Charlotte, September 16th and 17th. Feel free to reach out for that too.
Becker Private Equity & Business Podcast
Healthcare PE Trends: Innovation, Investment Shifts & Market Outlook with Holly Buckley of McGuireWoods LLP 5-22-25
But just appreciative of all of the work that went into it and what a great time we had last week.
Becker Private Equity & Business Podcast
Healthcare PE Trends: Innovation, Investment Shifts & Market Outlook with Holly Buckley of McGuireWoods LLP 5-22-25
And so I would say the investors that we had speaking and just in informal discussions with folks, we talked about optimism of increased deal flow coming up, but in certain sectors, not across the board. So sectors such as health tech, IT infrastructure, pharma services,
Becker Private Equity & Business Podcast
Healthcare PE Trends: Innovation, Investment Shifts & Market Outlook with Holly Buckley of McGuireWoods LLP 5-22-25
Thank you, Scott.
Becker Private Equity & Business Podcast
Healthcare PE Trends: Innovation, Investment Shifts & Market Outlook with Holly Buckley of McGuireWoods LLP 5-22-25
And even Medicaid-heavy areas, there was a fair amount of optimism, notwithstanding a fair amount of what's going on on the national landscape from a macroeconomic perspective, as well as a policy perspective, and then from a state law perspective. There's really been a strategic shift from traditional provider services to more diversified investments.
Becker Private Equity & Business Podcast
Focus vs Sprawling with Holly Buckley of McGuireWoods LLP 1-31-25
And for the lawyer side, it's clients. For the department side, it's people. So very similar. The most important thing in both of my disciplines are the people. And on the lawyer side, if you don't have clients, you don't have a business. And on the department side, if you don't have great people, you don't have a business.
Becker Private Equity & Business Podcast
Focus vs Sprawling with Holly Buckley of McGuireWoods LLP 1-31-25
And so making sure that the people are top front almost at all times is just critical. But then there's the strategy side of things. And as both a practicing lawyer as well as a department leader, it's really important to take the time out to build strategy for the department side. It's growth. It's how do we want to grow? Where do we need to grow? And how are we going to execute on that?
Becker Private Equity & Business Podcast
Focus vs Sprawling with Holly Buckley of McGuireWoods LLP 1-31-25
And in order to build that plan, you really need that focused downtime. And I frankly find flights very helpful for this. I find as sad as it may be, vacation's a good time for this, to be able to take some quieter time when there's less going on to actually focus on it.
Becker Private Equity & Business Podcast
Focus vs Sprawling with Holly Buckley of McGuireWoods LLP 1-31-25
On the lawyer side, building your strategy around business development, personal development, where you want to develop skills, same thing. You've got to take that quiet time to think it through. and put a plan in place and then revisit it periodically. Within both of the disciplines, there's also kind of the ongoing things you need to execute on.
Becker Private Equity & Business Podcast
Focus vs Sprawling with Holly Buckley of McGuireWoods LLP 1-31-25
So there's the constant focus, but then there's the need to focus on execution on things like business development, recruiting, billing, focusing on finances, and that's things that need continued attention, but less deliberate and continuous attention. and kind of the clients and the team items.
Becker Private Equity & Business Podcast
Focus vs Sprawling with Holly Buckley of McGuireWoods LLP 1-31-25
And then there's all of the other admin that just kind of, I wouldn't say it gets in the way, it's totally critical, but it takes a huge amount of time. And for that, I think the key is figuring out systems to both keep everything on track, but also keep the things off my plate that shouldn't be on my plate.
Becker Private Equity & Business Podcast
Focus vs Sprawling with Holly Buckley of McGuireWoods LLP 1-31-25
And I think the final thought, and this is one that I'm stealing from one of the senior associates I work with who's very, very smart, is the idea of... You have a lot of balls you need to keep in the air, but there's only one glass ball, and the glass ball is your family, and that's the ball you can't break.
Becker Private Equity & Business Podcast
Focus vs Sprawling with Holly Buckley of McGuireWoods LLP 1-31-25
And so you keep all the balls in the air and everything on track, but you make sure that when that glass ball starts to fall that you're there to catch it, and that's your number one priority and focus whenever it needs to be. So happy to chat through any of those, but those are the high-level thoughts.
Becker Private Equity & Business Podcast
Focus vs Sprawling with Holly Buckley of McGuireWoods LLP 1-31-25
Yeah, I think the one other thing I just reflected on is the importance of having a plan. And the plan needs to be living, breathing, and moving, but there's a lot of things that come your way from candidates to opportunities to shift and change. And I think unless you've got that distilled plan to run things through the filter of, you can end up very lost.
Becker Private Equity & Business Podcast
Focus vs Sprawling with Holly Buckley of McGuireWoods LLP 1-31-25
And I think it took me a little bit of time to come up with a plan that I liked, but I developed a kind of strategic recruiting plan
Becker Private Equity & Business Podcast
Focus vs Sprawling with Holly Buckley of McGuireWoods LLP 1-31-25
and growth plan that i i vetted with others who whose input was critical but now with each thing that comes in i'm able to run it through that filter and it and the plan changes the plan evolves it's not set in stone but i do think it's really important to have a strong sense of of what you're trying to achieve and how you want to achieve it um versus you know uh
Becker Private Equity & Business Podcast
Focus vs Sprawling with Holly Buckley of McGuireWoods LLP 1-31-25
flying by the seat of your pants, if you will. So I do think it's important to spend the time to do that. But I really enjoyed the discussion and the points that you picked up on.
Becker Private Equity & Business Podcast
Focus vs Sprawling with Holly Buckley of McGuireWoods LLP 1-31-25
Thank you, Scott.
Becker Private Equity & Business Podcast
Focus vs Sprawling with Holly Buckley of McGuireWoods LLP 1-31-25
Thanks, Scott. And as always, thanks for the discussion. I mean, I think I would love to say I have a perfect system and that I'm great at this. And I think as many can probably identify with the life is cyclical. And so at some points you do much better and at other points you're probably sprawling and not as focused as you should be.
Becker Private Equity & Business Podcast
Focus vs Sprawling with Holly Buckley of McGuireWoods LLP 1-31-25
But I think within different categories, there's different items and they need to be managed in different ways, right? So I'm both a practicing lawyer, that's kind of what I should be spending the majority of my time on. And I'm also the leader of the healthcare group. And so within both of those areas, There's the areas that I need to focus on very deliberately and continuously.
Becker Private Equity & Business Podcast
Healthcare Private Equity: Trends, Regulations, and Growth Areas with Holly Buckley of McGuireWoods LLP 2-21-25
One, the burden of production is much higher and the types of information that need to be produced are much greater. And so it's really important to get training for your deal teams and investment bankers because certain types of information that wouldn't have been previously disclosable now are, such as anything that's gone to the board related to the deal.
Becker Private Equity & Business Podcast
Healthcare Private Equity: Trends, Regulations, and Growth Areas with Holly Buckley of McGuireWoods LLP 2-21-25
And so it's just really important that those drafts are all very carefully put together and You're not just relying on the final versions. And it's really important to bring HSR Counsel in much earlier to avoid delays because it's no longer going to be something you can likely complete in five to seven days. So we've been kind of waiting for this one, wondering if it's going to get pulled back.
Becker Private Equity & Business Podcast
Healthcare Private Equity: Trends, Regulations, and Growth Areas with Holly Buckley of McGuireWoods LLP 2-21-25
But for now, it is actually live again.
Becker Private Equity & Business Podcast
Healthcare Private Equity: Trends, Regulations, and Growth Areas with Holly Buckley of McGuireWoods LLP 2-21-25
Yeah. So, I mean, anything that's below the threshold, which it's not just a straight enterprise value threshold, it's a complex equation to kind of get there, but around $120 million, if you're under that point, based on the calculations, you don't need to do an HSR filing. So that hasn't really changed.
Becker Private Equity & Business Podcast
Healthcare Private Equity: Trends, Regulations, and Growth Areas with Holly Buckley of McGuireWoods LLP 2-21-25
The bigger change is around the type of information that's going to be produced and where it's going to get more complicated, where The corporate structure is more complicated, but also to your point, Scott, where there is more overlap on geographic area and overlapping products and services or overlap on suppliers, that's where the burden is greater and it's going to be more complicated.
Becker Private Equity & Business Podcast
Healthcare Private Equity: Trends, Regulations, and Growth Areas with Holly Buckley of McGuireWoods LLP 2-21-25
So I guess an easy way to think about it is for the transactions that generally would have more of an antitrust impact, whether real or potential. Those are the deals that are going to have a much larger review, much larger production, and probably longer timeframes and more likely second requests.
Becker Private Equity & Business Podcast
Healthcare Private Equity: Trends, Regulations, and Growth Areas with Holly Buckley of McGuireWoods LLP 2-21-25
For the transactions where it's party A buying party B and party A is not currently in the line of business and doesn't have overlap, I think there's not going to be an awful lot of change, although the initial disclosure will be greater. So I think for those deals that do implicate antitrust laws, you can expect a longer, more painful ride.
Becker Private Equity & Business Podcast
Healthcare Private Equity: Trends, Regulations, and Growth Areas with Holly Buckley of McGuireWoods LLP 2-21-25
Yeah, so last year, one of the big state laws that everyone was very focused on was the California Senate Bill 3129, which would have, if it had gone through in certain of the forms that it was proposed, would have almost prohibited kind of MSOPC, kind of the private equity investment in medical and dental businesses. And Newsom ended up vetoing that law.
Becker Private Equity & Business Podcast
Healthcare Private Equity: Trends, Regulations, and Growth Areas with Holly Buckley of McGuireWoods LLP 2-21-25
It got all the way to his desk and then he didn't sign it and said, look, we already have a process for this. We're not going to kind of go this far and sign this. But now there's a new California bill that's proposed, which is Senate Bill 351. This came out in the last week or so. This is very, very watered down compared to what was proposed last year. And it's much more of a
Becker Private Equity & Business Podcast
Healthcare Private Equity: Trends, Regulations, and Growth Areas with Holly Buckley of McGuireWoods LLP 2-21-25
corporate practice bill than it is an antitrust bill or a real kind of transaction bill. But essentially, it prohibits PE funds and hedge funds from interfering with a professional judgment of physicians or dentists in making healthcare decisions and exercising power over specified actions, including decisions on billing and coding and patient care services.
Becker Private Equity & Business Podcast
Healthcare Private Equity: Trends, Regulations, and Growth Areas with Holly Buckley of McGuireWoods LLP 2-21-25
So in a way, this bill is somewhat of a nothing burger in its current form in that Those prohibitions are already live in the, as far as the medical board goes, and this would just be giving the Attorney General power over it. And so we don't consider this to be a big deal, but it's interesting that California after kind of failing last year to get their law passed, is kind of back again.
Becker Private Equity & Business Podcast
Healthcare Private Equity: Trends, Regulations, and Growth Areas with Holly Buckley of McGuireWoods LLP 2-21-25
We'll see if this evolves, if it gets modified, if it gets more prongs to it, and if it ends up creeping back towards 31-29. But really just interesting that California is back for another bite at the apple after the failing last year. And that goes with a number of other states, as we've talked about in other podcasts that are coming out with their
Becker Private Equity & Business Podcast
Healthcare Private Equity: Trends, Regulations, and Growth Areas with Holly Buckley of McGuireWoods LLP 2-21-25
AG laws to have pre-transaction filing notices and disclosure requirements, and just a lot of activity at the state level that's implicating transactions and creating a whole other level of work and time for investors.
Becker Private Equity & Business Podcast
Healthcare Private Equity: Trends, Regulations, and Growth Areas with Holly Buckley of McGuireWoods LLP 2-21-25
Yeah, I mean, I think it, in a way, just kind of creates something else to fight about, right? So I think you're right in general. PE funds are not looking to get in the middle of professional judgment.
Becker Private Equity & Business Podcast
Healthcare Private Equity: Trends, Regulations, and Growth Areas with Holly Buckley of McGuireWoods LLP 2-21-25
There's very few private equity professionals that hold medical degrees, and they're really looking to streamline the back end and to use capital for growth and improvement, but it creates something else that can be used as a sword or a shield.
Becker Private Equity & Business Podcast
Healthcare Private Equity: Trends, Regulations, and Growth Areas with Holly Buckley of McGuireWoods LLP 2-21-25
And I don't necessarily think this is going to be super impactful, but I think it will continue to create a disincentive for some folks to invest in California as it continues to be a very difficult state.
Becker Private Equity & Business Podcast
Healthcare Private Equity: Trends, Regulations, and Growth Areas with Holly Buckley of McGuireWoods LLP 2-21-25
The final thing I was going to flag is what I think is just a super interesting trend. And it goes with the theme of funds looking, healthcare funds looking at things to invest in that aren't direct reimbursement, direct provider services companies.
Becker Private Equity & Business Podcast
Healthcare Private Equity: Trends, Regulations, and Growth Areas with Holly Buckley of McGuireWoods LLP 2-21-25
Hey, Scott, and thanks as always for having me on. A couple of things I think are super interesting that are either impacting deals or just interesting trends. The first is the much anticipated new HSR rule is actually live and went into effect on February 10th. So this new rule is projected to lead to a substantial increase in the time and effort required to complete an HSR filing.
Becker Private Equity & Business Podcast
Healthcare Private Equity: Trends, Regulations, and Growth Areas with Holly Buckley of McGuireWoods LLP 2-21-25
And it's not that funds are not making those investments, but we're seeing a big trend toward diversification to invest in things in the healthcare orbit, because it's still just a very dynamic with a lot of potential and a lot of room for improvement. But one of the areas that I think is super interesting is funds investing in healthcare consulting companies.
Becker Private Equity & Business Podcast
Healthcare Private Equity: Trends, Regulations, and Growth Areas with Holly Buckley of McGuireWoods LLP 2-21-25
And I was poking around this weekend and found a fair amount of these. And we've seen VMG, the kind of valuation, other healthcare consultant services business has PE investment. Coca Group took investment from Trinity Hunt. Chartus from Blackstone and Chartus is the parent company of Gerard, which is the healthcare PR firm.
Becker Private Equity & Business Podcast
Healthcare Private Equity: Trends, Regulations, and Growth Areas with Holly Buckley of McGuireWoods LLP 2-21-25
And we're also seeing investment in consulting companies in the pharma services sector. And so just an area that is interesting as a professional services professional myself to see private equity kind of moving into these other areas. professional service spheres and kind of looking at how they can grow and combine and elevate. So I think super interesting.
Becker Private Equity & Business Podcast
Healthcare Private Equity: Trends, Regulations, and Growth Areas with Holly Buckley of McGuireWoods LLP 2-21-25
We'll be talking about that at our conference in May as well. But just yet another area that we're going to see a fair amount of developments.
Becker Private Equity & Business Podcast
Healthcare Private Equity: Trends, Regulations, and Growth Areas with Holly Buckley of McGuireWoods LLP 2-21-25
No, I mean, I think it's a lot of the same stuff we've been talking about. We're seeing a fair amount of exits, um, both kind of getting started and also underway and having just closed. So the exit market seems to be relatively strong, also seeing some good new deals come to market.
Becker Private Equity & Business Podcast
Healthcare Private Equity: Trends, Regulations, and Growth Areas with Holly Buckley of McGuireWoods LLP 2-21-25
And so I think we're still optimistic this is going to be a good year, probably not a great year, but a really solid year. But the three we've talked about are the ones that are really top of mind for me.
Becker Private Equity & Business Podcast
Healthcare Private Equity: Trends, Regulations, and Growth Areas with Holly Buckley of McGuireWoods LLP 2-21-25
Thank you.
Becker Private Equity & Business Podcast
Healthcare Private Equity: Trends, Regulations, and Growth Areas with Holly Buckley of McGuireWoods LLP 2-21-25
So that's for those deals that are over the HSR threshold. And I'll apply unless the Congress or the FTC revises or revokes the rule. And there's also a lawsuit currently challenging the rule. But for now, we're up and running with the new rule. Few things to consider with the new rule.