Summary Cards

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Health insurance M&A gains steam as regional companies seek edge

Modern Healthcare Nov 29, 2025
Deals M&A
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Health insurance mergers and acquisitions saw increased activity in Q3, driven by the need for scale and to address regulatory and cost pressures.
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Trump, GOP head into Thanksgiving without ACA subsidies fix

Modern Healthcare Nov 29, 2025
Regulation Policy Reimbursement
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President Trump expressed reluctance to extend expiring Obamacare subsidies, despite a White House proposal, creating uncertainty for millions facing premium increases.
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Healthcare earnings top S&P 500 behind drug, hospital demand

Modern Healthcare Nov 29, 2025
M&A Reimbursement Policy
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American public healthcare companies, including pharmaceutical firms, hospitals, and medical device manufacturers, reported strong Q3 earnings, outperforming other S&P 500 industries.
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Medicare Advantage network oversight is rare, CMS records show

Modern Healthcare Nov 29, 2025
Regulation Policy
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Federal oversight of Medicare Advantage (MA) network adequacy is lax, with CMS rarely enforcing rules despite widespread provider-insurer separations impacting 35 million members.
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Baxter recall of Life2000 Ventilators is most serious type: FDA

Modern Healthcare Nov 29, 2025
Regulation Policy
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The FDA issued a Class I recall for Baxter's Life2000 Ventilation System due to a cybersecurity vulnerability.
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FW: The Daily Brief, presented by BRG: 11/24/25

james@lorientcap.com email Nov 28, 2025
Deals Regulation Reimbursement M&A
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Healthcare technology M&A remains robust with GE HealthCare acquiring cloud software provider Intelerad for approximately $2.3 billion and Abry Partners targeting a $1 billion continuation fund for software provider Centauri Health. Private equity is actively focusing on behavioral health, home-based care, and HCIT, as evidenced by MDI NetworX's acquisition of Cobalt MedPlans to enhance tech-enabled payer services and EverTrue's expansion into home care.
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McKinsey VBC Report

james@lorientcap.com email Nov 28, 2025
Regulation Policy Reimbursement Market Intelligence
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The US healthcare sector is undergoing a significant shift towards lower-cost, outcome-focussed models, driven by CMS policies encouraging care transitions to settings like home health. This trend, alongside the integration of healthcare technology and analytics, is unlocking substantial cost savings, including 3-5% in behavioural health, despite some value-based care firms experiencing recent financial challenges.
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FW: Healthcare Industry Insights: Value-Based Care (VBC) Industry Update

james@lorientcap.com email Nov 28, 2025
Policy
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A McKinsey report highlights Value-Based Care (VBC) models with significant cost-saving potential, particularly shifting surgical care to home health settings (8-10% savings) and leveraging healthcare technology for payer-led data analytics (2-3% savings). These trends support investment in home health and healthcare SaaS platforms.
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William Blair Healthcare AI RCM Report

james@lorientcap.com email Nov 28, 2025
Deals Regulation Policy Reimbursement M&A
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The healthcare AI Revenue Cycle Management (RCM) market is experiencing significant M&A and funding activity, with major deals including R1 RCM's $8.9B acquisition by TowerBrook and Clayton, Dubilier & Rice, and Waystar's $1.25B acquisition of Iodine Software. This dynamic reflects a broader shift towards AI-powered software solutions, projected to grow the RCM software Total Addressable Market from $25B in 2024 to $42B by 2030, driven by providers bringing RCM functions in-house. New CMS regulations mandating prior authorisation APIs by 2027 further accelerate AI adoption, promising substantial efficiency gains and cost savings.
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FW: GCG Q3 2025 Healthcare Industry Update

james@lorientcap.com email Nov 28, 2025
Deals M&A
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The Q3 2025 Healthcare Industry Update reveals strong sector resilience with 883 transactions, driven by strategic buyers and improved financing conditions. Notably, AI-driven healthcare platforms are gaining significant momentum, reflecting investor focus on efficiency and scalability within the high-priority healthcare technology sector.
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Harris Williams RCM Report

james@lorientcap.com email Nov 28, 2025
Deals M&A Regulation Market Intelligence
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The high-priority Revenue Cycle Management (RCM) sector is seeing robust M&A, including Waystar's $1.3B acquisition of Iodine Software and New Mountain Capital's formation of Smarter Technologies, an AI-enabled RCM suite. This activity is fuelled by strong demand from behavioral and home health markets, alongside evolving regulatory landscapes.
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FW: Healthcare Industry Insights: Revenue Cycle Management (RCM) Industry Update

james@lorientcap.com email Nov 28, 2025
Reimbursement Policy
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Payer denials and audits are significantly increasing across healthcare settings, posing major revenue cycle management challenges for providers. Coding-related denials are up 26% year-to-date, while Medicare Advantage denied claims now average $1,000, leading to longer payment lag times.