Highlights of the 22nd McGuireWoods Healthcare Private Equity and Finance Conference

McGuireWoods convened its 22nd Annual Healthcare Private Equity and Finance Conference in Chicago on April 29-30, 2026, gathering investors, operators, lenders, advisers and executives from across the country. The two days came as healthcare private equity faces heightened regulatory scrutiny, reimbursement uncertainty and AI-driven disruption amid an improving M&A market.

One theme cut across the two days: Investors with operational depth, regulatory fluency and a long view remain best positioned across healthcare services, pharma services, digital health and adjacent sectors. Macro and policy headwinds persist, but the room was cautiously optimistic that deal activity is regaining momentum into the back half of 2026. Among providers and health systems, speakers noted growth opportunities in lower-cost settings (surgery centers, urgent care) and emerging areas including AI-enabled healthcare services, value-based care platforms, cardiology and lab diagnostics. Panelists emphasized that the strongest partnerships balance economic performance with physician alignment, clinical quality and expanded patient access.

Day 1 keynote bestselling author Michael Lewis reflected on his inspirations for his novels and the lessons he learned from each book before a full Ritz-Carlton ballroom. Day 2 keynote technologist Abigail Hing Wen explored AI’s transformation of healthcare, including the regulatory landscape, generational implications and the technology’s industry-specific impact.

Read on for seven core themes from the conference.

1. Healthcare Private Equity Market Conditions Continue to Improve

Healthcare private equity activity improved over the prior two years, though the market remains selective and quality-driven. Sponsors and lenders pointed to greater financing availability, better alignment on valuation between buyers and sellers, and a deeper pipeline of platform and add-on opportunities. Setting the tone for the conference, Christopher W. Kersey of Havencrest Capital, in a fireside chat with Scott Becker, McGuireWoods partner and publisher of Becker’s Hospital Review and Becker’s Healthcare, predicted that the next three years will be the strongest stretch for healthcare PE investment in at least a decade. He further laid out the operational playbook for conference goers looking to win big in healthcare.

Buyers continue to prize operationally mature businesses with solid compliance infrastructure, differentiated growth and durable reimbursement profiles. Premium assets remain intensely competitive; weaker platforms face valuation pressure and longer paths to close. The contrast with last year is striking. In 2025, the dominant questions were when financing would return and how platforms would solve their people problems. In 2026, financing is no longer the bottleneck, and the headline question has shifted to who buys the next wave of platforms.

Speakers also pointed to renewed interest in healthcare services and adjacent sectors where investors can capture healthcare tailwinds without direct reimbursement exposure, focusing on tech-enabled services, pharma services, revenue cycle management, healthcare IT, clinical workflow technology, concierge medicine and outsourced business services.

The question that came up over coffee between sessions more often than any other: Who is the next buyer? Panelists generally agreed that exits remain choppy. The IPO window has only cracked open, sponsor-to-sponsor activity is not what it was a decade ago, and continuation funds and other GP-led structures continue to fill gaps. As early 2020s platforms come to market over the next 18 to 24 months, that next wave of trades is expected to provide needed exit liquidity and seed inventory for a new generation of platforms.

2. AI Shifts From ‘Future Opportunity’ to Investable Thesis and Operational Imperative

AI was again a dominant thread, but this year the conversation moved from theory to execution.

Panelists described AI’s expanding role in clinical documentation, revenue cycle, labor efficiency, patient engagement, predictive analytics and administrative burden reduction. Companies that build AI into core workflows without compromising compliance or data integrity will pull ahead. In value-based care, AI is becoming essential to making thin-margin models work at scale, with panelists describing adoption as “not an if but a when.”

Investors flagged caveats: data governance, cybersecurity, regulatory oversight and integration complexity. One panelist argued that “AI fails at the strategy, not the model,” emphasizing that governance structures and clean data architecture must be in place before tools are deployed. IT infrastructure readiness, not just willingness to adopt, remains a genuine bottleneck.

Several sponsors between sessions acknowledged evaluating whether AI will displace portions of their platforms’ profitability, a dynamic pushing more capital into subsectors viewed as insulated from direct AI substitution. The RCM panel made the point bluntly: With AI-first revenue cycle entrants launching almost weekly, winners will pair deep domain expertise with AI tooling. The broader takeaway: AI is a chance to rethink workflows, but winning platforms will use it for advantage, not as a substitute for operational discipline.

AI tools are themselves an active investment focus. Nearly every meeting our team had included funds asking about tech-enabled tools, whether as standalone investments, platform accelerants, or underwriting differentiators. Sponsors historically focused on services are now willing to underwrite the technology layer, and the line between “healthcare services” and “healthcare technology” keeps blurring.

3. Lending Markets Show Increased Stability and Competition

Lenders and other debt market participants described a more constructive financing environment characterized by increased liquidity and heightened competition. Direct lenders, private credit funds and banks all signaled strong appetite for healthcare deals, particularly scaled platforms with predictable cash flows.

Although leverage in some subsectors remains below historical highs, terms have become more borrower-friendly as competition intensified. Panelists highlighted continued growth in private credit, more aggressive bank competition, active refinancing markets and creative structures to bridge valuation gaps. Covenant flexibility improved for top-tier borrowers, while operational performance and reimbursement diligence remain key underwriting considerations.

Private credit continues to gain market share due to its speed, certainty and flexibility, while banks are competing more aggressively for larger, high-quality credits, resulting in downward pressure on pricing and improving structural flexibility for borrowers. However, the market remains bifurcated: Strong demand exists for scaled, sponsor-backed platforms, while smaller or more complex credits face greater selectivity.

Underwriting remains disciplined, particularly in subsectors facing reimbursement or regulatory uncertainty, with the most favorable terms reserved for borrowers demonstrating stable operations and credible growth profiles. Overall, panelists described a market that is increasingly borrower-friendly at the top end but still defined by selectivity and discipline beneath the surface.

4. Specialty Care Subsectors Draw Differentiated Investor Interest

Several subsectors including behavioral health, post-acute, infusion, specialty physician platforms, DSOs and women’s health continued to draw heavy investor interest. The flip side was just as clear: subsectors with heavy direct reimbursement exposure, particularly physician-heavy platforms with material Medicaid concentration, drew more cautious commentary. Funds are not walking away from those deals, but they are looking for other opportunities to diversify the fund.

Behavioral health remained a focal point. Panelists in the future of behavioral health panel pointed to durable demand, persistent provider shortages and growing payer support for expanded mental health and SUD access as the core drivers. Fragmentation and the broader societal recognition of behavioral health needs leave a long runway for consolidation and platform-building. Many funds also called out a heavy and continuing focus on intellectual and developmental disabilities platforms, in which demand, payer dynamics and a highly fragmented provider base make the space especially attractive.

Specialty practice management platforms continue to draw interest, though a number of funds remain wary of subsectors with heavy Medicaid or other government-payor exposure given anticipated rate pressure. The dental area illustrates how much platform formation is happening across a single subsector: Panelist on the dental service panel explained how large-scale consolidators and emerging platforms are coexisting and competing for the same dentists. Panelists also acknowledged that growing regulatory scrutiny, particularly expanding state healthcare transaction review, is reshaping deal structures, timelines and diligence.

5. Consumer-Driven and Personalized Care Models Continue to Gain Investor Attention

Investor interest in consumer-oriented healthcare platforms continues to broaden, particularly around models that move care closer to the patient. Areas drawing attention include home-based care, longevity, tech-enabled services, HCBS, women’s health, and other consumer-driven models. Panels on personalized care and rural healthcare delivery grounded the discussion. The democratization of concierge medicine is accelerating as PE platforms build scalable, subscription-based models at lower price points, while adjacent categories like med spas and HRT clinics serve as entry points toward comprehensive wellness relationships. Investors also pointed to a replicable playbook for rural expansion, leveraging predictive site-selection, value-based reimbursement, and AI-powered patient engagement tools.

The shared takeaway: personalized, accessible care outside traditional clinical settings represents a meaningful long-term opportunity. Platforms most likely to succeed will pair clinical credibility with differentiated consumer experiences. Consumer-facing models are attractive precisely because they sit further from direct reimbursement risk, a counterweight to the more exposed specialties discussed in Section 5.

Cash-pay and subscription-based models offer strong revenue visibility, simplified underwriting, and insulation from reimbursement risk. Panelists expressed high conviction that demographic tailwinds (an aging population, normalization of wellness treatments, favorable longevity medicine regulation, and continued federal investment in rural health) will make democratized, personalized care an expanding PE category over the next three to five years.

Rural delivery drew more sustained attention than in prior years. Over 90% of rural counties qualify as primary care shortage areas, enabling value-based models to achieve rapid patient acquisition at lower cost than urban settings. Women’s health, longevity, concierge and HCBS each drew enthusiasm, with sponsors gravitating toward platforms that can scale differentiated patient experiences without outsized clinical or reimbursement risk.

6. Regulatory Complexity Remains Central to Investment Strategy

Regulatory and enforcement issues sat at the center of nearly every panel. Investors and operators alike emphasized the need for proactive compliance infrastructure as federal and state scrutiny of healthcare deals continues to widen and deepen. Two specific touchpoints generated significant discussion. McGuireWoods Consulting hosted a roundtable tracing how the legislation will land across each part of the capital stack and care continuum. Separately, panelists repeatedly returned to Oregon’s recent corporate practice of medicine changes and the broader patchwork of state healthcare transaction notification and approval laws as the most active near-term areas of risk. McGuireWoods maintains a state-by-state tracker on these regimes.

Several panelists reframed the regulatory picture as opportunity, not just risk. Disciplined investors who can navigate fragmented, highly regulated markets are the ones less experienced participants leave on the table. The practical consequence is that regulatory diligence and government affairs are no longer back-office; they now sit alongside commercial and financial diligence from sourcing through exit.

7. Operational Maturity Is New Differentiator, With AI as One Input

Across nearly every session, investors returned to a familiar refrain: Management quality, culture and execution are everything. The bar, though, has moved. Sponsors increasingly want CEOs who can run an integration playbook, redesign physician compensation without losing alignment, manage rising labor costs and produce portfolio-grade data on demand. AI fluency is one input on that list. While important, it is not the whole story. The right leadership team is what separates a platform that compounds from one that stalls.

The differentiators sponsors weigh most heavily in platform evaluation and underwriting now look more like an operating checklist than a list of platitudes: scalable integration capability, physician compensation redesign, talent strategy in a tight wage market, embedded compliance culture, governed AI deployment and portfolio-grade data and analytics.

Sponsors are also spending more time before close evaluating whether targets can integrate add-ons quickly, deploy technology at scale and absorb regulatory and reimbursement change without a hit to operations. Those capabilities, and not topline growth alone, are increasingly what the next buyer underwrites. The corollary, raised in several panels, is that selling well now requires building operational maturity earlier in the holding period: standing up integration playbooks, professionalizing finance and data functions, and getting compliance and physician alignment to a place that survives diligence on the next trade. Platforms that wait until the sale process to build those capabilities are the ones that face the longer paths to close discussed in Section 1.

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Looking Ahead And Heading West

This year’s conference made clear where healthcare private equity is heading: heavier on operations, deeper on technology, more demanding on compliance. None of the macro uncertainty is going away, but the tone in the room was unambiguous; healthcare will keep offering long-term opportunity for investors who do the work. The next 12 months will be defined by exit pacing, the next wave of platform formations, AI deployment at scale, and how sponsors price in a moving state regulatory map.

After 22 years in Chicago, McGuireWoods is excited to share that HCPE will head west for the first time in conference history for HCPE 2027. We are grateful to our venue partners, including CloudBar360, with its panoramic view of the city, and the Museum of Contemporary Art, as well as our conference sponsors, speakers and attendees who helped grow HCPE to what it is today.

We look forward to building on that tradition and welcoming everyone to Phoenix at The Arizona Biltmore for HCPE 2027.

Thank you also to the sponsors who made this year’s conference possible. See the full list of our 2026 sponsors. For questions about future conferences, contact [email protected].