Hello September! Amazingly, we've been publishing this newsletter for almost nine months, and we keep finding more parts of healthcare payments to cover. We are deeply grateful for your feedback (and a few compliments) which help us to keep making improvements. We are hearing that you like the deal news and AI items. The CEO Chat is mostly moved to its own bi-weekly email, with a mention here. We're planning to focus the rest of the space here on one main topic each issue. This week, we are covering what the big banks are doing in healthcare. Please keep the comments coming - you can email us here.
DEAL NEWS
U.S. Bank acquires all of Salucro
U.S. Bank announced on August 22 that it acquired Tempe, AZ-based Salucro Healthcare Solutions LLC. Salucro had been known as a payment platform, but more recently was positioning itself more broadly as a seller of patient engagement solutions including online bill pay solutions, print and digital statements, omnichannel communication options, and multiple payment integrations. U.S. Bank, part of U.S. Bancorp (NYSE: USB), invested in Salucro in 2022 and had been reselling Salucro through its Elavon payment processor as MedEpay.
While U.S. Bank did not disclose the purchase price, FinMed Partners estimates that the bank paid between $200-225 million for all of Salucro. This is based on Salucro's 130 employees and assumes the company has $40-45 million in annual revenue.
With Salucro off the table, Sphere/ TrustCommerce is another healthcare payments company likely drawing interest from potential acquirers. We would expect banks to be in this mix (see below).
On August 27, Durham, NC-based PatientPay and Tampa, FL-based ClearGage announced the two payments companies were combining. Together both companies estimate they will serve 1,600 healthcare organizations. PatientPay will be able to take advantage of ClearGage's status as a registered PayFac.
Tom Furr, CEO of PatientPay, previously shared his thoughts on his company's right to win in our CEO Chat series. Ryan Zemmin, CEO of ClearGage, said in the companies' joint press release that "We’re thrilled to join forces with PatientPay to continue developing innovative technology that aligns the consumer experience with the financial goals and needs of healthcare organizations."
HealthEquity (NASDAQ: HQY) announced a partnership with Columbia, MO-based Paytient on September 3 in which HealthEquity will sell Paytient's Health Payment Account (HPA). HealthEquity is the largest Health Savings Account (HSA) custodian in the U.S. HealthEquity's webpage dedicated to the partnership describes Paytient's HPA as "an employer-sponsored benefit offering an interest-free line of credit that helps employees pay for unexpected healthcare expenses".
We have heard from multiple sources that First Dollar, an early stage HSA infrastructure company looking to take share from WEX, Alegeus and other established players, may be in the process of selling itself to Inspira Financial (FKA Millennium Trust and PayFlex). We have also heard that this is not the case, so take this as rumor for now.
Some of you may have heard that Bill Davis, Founder, Chairman & CEO of ECHO Health, passed away recently. Bill founded ECHO in 1997, and grew it into a payments network that settles over 500 million claims and transmits over $110 billion in payments each year. We first encountered ECHO when working with a client offering a solution similar to ECHO's Simplicity product. We were impressed with the company's quiet innovation and growth.
We understand that ECHO received frequent interest from potential buyers over the years, but always chose to remain independent. This may still be the case, but it is also possible that an interested party will make an offer that current owners will find difficult to refuse.
BANKS AND HEALTHCARE
We thought it would be instructive to take a brief look at the healthcare plays of major U.S. banks. In the interest of brevity we are only including money center and other banks with a sizable position in healthcare payments. We are happy to hear about any we missed that you feel should be included in a later addendum...
Note: we assume that all banks offer basic banking and financial services for healthcare providers and payers including lines of credit, treasury services, some capital markets services, equipment lease financing, and so on. We'll highlight here the areas in which these banks focus beyond table stakes.
Bank of America
Source: Bank of America Healthcare Payment Solutions webpage
Bank of America (NYSE: BAC) serves over 2,000 hospital clients and has nearly 20,000 relationships with U.S. healthcare providers. It offers a wide range of financial management services for healthcare organizations. The most visible healthcare move that the bank has made recently is its 2021 acquisition of healthcare payments company AxiaMed (now known as Bank of America Healthcare Payment Solutions). Bank of America healthcare solutions executive Simon Abtalion provided more color on AxiaMed and the transition to cashless healthcare in this PYMNTS article.
Wells Fargo
Wells Fargo (NYSE: WFC) has long had a strong focus on the healthcare market, building dedicated teams to serve different healthcare segments including hospitals and health systems, physician practices, assisted living and senior care facilities, as well as DME, pharma and health IT. Wells Fargo's Merchant Services division served as an early acquirer for InstaMed, and the bank offers the Wells Fargo Health Advantage Card to help patients pay for dental, vision, hearing, and veterinary care (similar to the better known CareCredit card from Synchrony Financial).
PNC Financial Services Group
PNC (NYSE: PNC) has a business unit called PNC Healthcare specifically organized to serve the healthcare industry (targeted at organizations with more than $10 million in revenue - smaller organizations are served by PNC "Healthcare business banking"). According to the bank's website, "The PNC Healthcare team has more than 500 dedicated employees who have served more than 4,000 healthcare organizations over the past 30+ years." PNC offers Treasury Management, revenue cycle management (RCM) and electronic payment solutions geared specifically to the needs of healthcare organizations. In 2021, PNC acquired Tempus Technologies which - while it serves many industries - is a leading payment gateway for patient payments in Epic MyChart and in-person payment processing for Epic-based providers. PNC publishes a Healthcare Matters newsletter twice a year.
U.S. Bank
U.S. Bank is the lead bank of U.S. Bancorp (NYSE: USB). It has built up a significant presence in healthcare in a couple differentiated ways. First, U.S. Bank owns Elavon, a leading payment processor. Elavon has a solid presence in healthcare, and it is this unit into which U.S. Bank is integrating its recent Salucro acquisition. (Elavon has acquired tens of thousands of healthcare providers from athenahealth alone, which has an exclusive reseller agreement and lockbox services with Elavon/ U.S. Bank). Second, U.S. Bank offers services to automate and optimize revenue cycle management. This is part of its larger Healthcare Finance Services business. Third, the bank recently launched an initiative to better serve small/ mid-size medical practices (up to $25M revenue) including banking, payments and wealth management services.
J.P. Morgan Chase
Source: J.P. Morgan Healthcare Payments Solutions webpage
J.P. Morgan Chase (NYSE: JPM) has a multifaceted approach to healthcare. The bank has run the annual J.P. Morgan Healthcare Conference in San Francisco since acquiring Chase in 2001, which itself had acquired Hambrecht & Quist the year earlier and with it, the healthcare conference H&Q had run since 1983. J.P. Morgan has loosely consolidated a variety of healthcare banking, treasury, payments and other operations into a Health Care group. The bank shelled out $500 million for healthcare payments gatewayInstaMed in 2019, its largest acquisition at the time since the 2008 financial crisis. InstaMed and other internal groups produce healthcare payments thought leadership for J.P. Morgan, contributing to its positioning as a leader in healthcare banking and payments. J.P. Morgan has integrated healthcare payments/ InstaMed with Chase Payment Solutions (FKA Chase Paymentech), which is one of the leading payment processors across all industry verticals.
Citigroup
Unlike its peers profiled here, Citibank, part of Citigroup (NYSE: C) has not made visible investments in payment processing, patient payment gateways, revenue cycle management solutions, or other specialized assets targeted specifically at healthcare. What Citi has done is in 2021, announced an internal reorganization within its banking, capital markets and advisory (BCMA) division to create a new “supergroup” for healthcare, consumer and wellness. It hired a former Goldman Sachs healthcare investment banker, Chuck Adams, to run the new group.
KeyBank
KeyBank, part of KeyCorp (NYSE: KEY) serves nearly 10,000 healthcare clients across the U.S. including hospitals, physician practices and others. KeyBank provides many of the same investment banking, treasury, real estate and equipment financing and other banking services as its peers. But it does have dedicated focus on healthcare, including hiring advisors with specific healthcare knowledge, and is offering digital transformation support to help healthcare organizations modernize their operations (e.g., digitizing accounts receivable and payable processes). KeyBank is helping health systems develop more consumer-centric delivery platforms, and is ranked #1 in middle market healthcare M&A. KeyBank has been publishing healthcare-specific POV, such as this one.
CEO CHAT
Joshua Silver, CEO, Rainforest
Click here to read our latest CEO Chat, with Joshua Silver of embedded payments company Rainforest.
House republicans slam CFPB medical debt proposal. House Republicans write to CFPB Chairman Rohit Chopra expressing concerns about proposal to remove medical debt from consumer credit reports. (PYMNTS)
ADDITIONAL RESOURCES
Deal Tracker. Regularly updated list of healthcare payments related transactions since November 2023. Includes 27 deals through August 2024.
Conference List. Rolling twelve month look ahead at conferences and other events covering healthcare payments, revenue cycle, fintech and related areas. Updated through September 2025.
CEO Chat. Thoughts from healthcare payments CEOs on the problem their company was founded to solve, their right to win, and plans for the next 12 months.
Newsletter Archive. News, trends, and insights from the healthcare payments industry compiled in our bi-weekly newsletter. Last six months of newsletters.
Epic MyChart. Excel sheet with full listing of all Epic MyChart instances as of May 2024, categorized by state, provider type and specialty.
All of these resources can also be accessed at the FinMed Partners Insights page.
Coming Soon to Nashville
We'll be in Nashville from October 1-3 - drop us a line at info@finmedpartners.com to arrange time to meet while we're in town!
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FinMed Partners is a management consulting and advisory business focusing at the intersection of payments/ fintech and healthcare. Our founders have developed deep expertise from decades of experience with health IT companies, healthcare providers and many players within the payments ecosystem. Investors, boards and executive teams work with us to maximize business value through strategic input and tactical execution.
FinMed Partners LLC, 34 Long Avenue, Belmont, MA 02478, United States
