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title: "Healthcare Payments #47: Practice Financing Deep Dive"
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News, trends and insights from the leading healthcare payments consultancy ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­    ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­  

| View in browser Issue #47 October 14, 2026 Welcome to our October issue. This month we're introducing a longer-form article format that takes a deep dive into a healthcare banking and payments topic. After an extensive naming exercise, we've decided to call it - this is really ingenious - "Deep Dives"! Periodically the newsletter will feature these pieces that explore a topic of interest in more detail. Deal News will return in November. With our upcoming Healthcare Fintech Forum (Nashville, November 9-11) focused on Embedded Financial Services, this Deep Dive looks into Practice Financing. If there's a topic you think we should cover in a future edition, please drop us a line here. Speaking of our event, we have just a few spaces left. If you're interested in joining the inaugural (and only) Healthcare Fintech Forum and haven't received your personalized invitation, you can request one here. This link has a current list of companies attending the event.  Reach out to us here if you'd like more information about our firm, our consulting & advisory work, email marketing services (including newsletter sponsorship for 2027, distribution to 20,000+ subscribers, and sponsorship opportunities for the 2027 Healthcare Fintech Forum. SPONSORED BY: BLUEFIN With thousands of U.S. deployments, Bluefin helps Epic health systems get paid faster while reducing risk and costs through PCI-validated encryption and a secure MyChart checkout that keeps card data off hospital systems. Click here to learn more. FINMED DEEP DIVE Practice Financing Market Practice financing is the money clinicians use to open, buy, equip and run a practice. That covers startup loans, working capital to cover slow insurance payments, acquisition loans, equipment financing and mortgages on the building. The dynamics of practice financing look very different among independent medical, dental, and veterinary clinics. Specialty Breakdown Medical groups have experienced the most consolidation. By 2024, the AMA estimated that only 42% of physicians worked in private practice (down from 60% in 2012). Other sources cite more extreme numbers – Avalere/ Physicians Advocacy Institute data indicates that by January 2026, 82% of U.S. physicians worked for a hospital or another corporate employer, including insurers and private equity. Fewer owners means fewer acquisition loans, so lenders serving medical groups lean toward working capital that covers reimbursement gaps, and equipment and real estate loans. Dentistry has consolidated far less. About 73% of dentists still own their practice according to the ADA. Slower buying keeps independent owners, and associates who want to become owners, in the market for loans. Veterinary medicine has more than 30,000 practices. Mars (Banfield, VCA, BluePearl) and private equity platforms have built large chains especially in specialty and emergency care, but AVMA data suggest about 65% of general practices are still independent. With 39% of veterinarians 55 or older, many independent practices will change hands in the next decade, and the buyers will need financing. Overall, we estimate that physicians own about 90,000 practices, the dental market counts roughly 100,000 independent offices, and veterinary care has 19,000 independent general practices. Bank Lending Anchors the Market Banks still lead in bigger, long-term lending. SBA 7(a) loans, up to $5 million with as little as 10% down, are the workhorse for acquisitions. Live Oak Bank, which started as a veterinary lender, competes with big national and super regional banks such as Bank of America Practice Solutions, Huntington Bank, PNC Bank, and U.S. Bank. In May 2026 U.S. Bank launched a startup loan for dental and veterinary practices supported by more than 100 dedicated healthcare bankers. Healthcare drew roughly $3.2 billion in SBA approvals in fiscal 2024, about 9% of volume, by one lender’s analysis (Crestmont Capital). Role of Fintechs Specialists compete on speed and industry knowledge. Provide, the lending fintech Fifth Third Bank bought in 2021, aims squarely at dentists and vets (“people keep caring for their teeth and their pets even when money gets tight”). Venture money is here too. Panacea Financial raised $62 million in a Series B round in 2025 and in June 2026 the American Association of Orthodontists endorsed it for member loans. Panacea lends through Primis Bank, which held $583 million of its loans at mid-year (includes some non-practice lending). The model is a classic fintech in front and bank charter behind. Lenders serve the consolidators too: Live Oak has a sponsor-finance team for dental roll-ups. Entry of Payments Companies Square, Stripe and Adyen process card payments, which gives them a live view of a merchant’s sales that banks do not have unless they own a processor (U.S. Bank and JP Morgan Chase). Square underwrites on real-time transaction data, has originated more than $32 billion in loans since 2014, and averages a loan of nearly $10,000, and markets its payment and scheduling tools to dentists, optometrists and dermatologists. Stripe Capital looks at a business’ payment volume and history on Stripe to make lending offers. Adyen Capital works through software platforms, offers $500 to $50,000 on terms up to nine months, and takes the credit risk itself. These loans are small and short, so they compete for working capital, not acquisitions or real estate. A flat fee can also add up to more than a bank rate when a practice repays quickly. The bigger point is who holds the customer. The company that processes a practice’s payments sees its cash flow first and can make an offer before a banker knows the practice exists. Rise of Embedded Finance Access to capital to fund different financing needs is spreading to the practice management (PM) software used by medical groups, dental offices, and vet clinics. The payment companies mentioned previously are often embedded natively into PM systems, including lending options. Parafin, which mostly operates outside healthcare but does have Mindbody as a customer, underwrites on sales history and delivers offers inside software platforms. Weave, the communications and payments software vendor recently acquired by Francisco Partners, signed a multi-year deal with Stripe in 2023 to process payments for its thousands of U.S. healthcare practices and added Stripe Capital as an embedded financing option. Other Ecosystem Partners Distributors and software vendors are also becoming channels for practice loans. Henry Schein’s medical finance arm offers working capital, equipment and real estate loans through third-party lenders, and Covetrus, the animal-health distributor and practice-software company, refers vet practices to partner lenders for equipment and project financing. The End Game As fintechs continue to pressure traditional lenders in the practice financing space, banks are already pushing back. The Chief Enterprise Payments Officer for Huntington Bank has been very public in saying "We won't cede any ground” to fintechs, adding "there's a tremendous opportunity in embedding banking with payments." (American Banker) Expect bank investment in third-party technology, integration with software platforms, and addition of healthcare sales teams to ramp up in the next couple of years. But at the same time, the payments companies and other fintechs are not backing down and will be pushing harder than ever to win sticky relationships with platforms both in healthcare and other industries. For a practice owner, the first capital offer may now come from the payments or software vendor before a banker calls. The vendor already sees the practice’s collections, so it can pre-approve without a loan application. For banks and specialty lenders the choice is to supply the capital behind these platforms, as Primis does for Panacea, or to compete with them for the customer. Small working-capital advances suit this model easily. Acquisition and real estate loans still call for bank underwriting. CEO CHAT Emma Loftus, EVP, Head of Treasury Management, PNC Bank Emma Loftus, EVP and Head of Treasury Management for PNC Bank, Joined us recently to explain how healthcare organizations are under pressure to do more with less, making the way money moves through a healthcare provider more important than ever. Emma explains how Treasury has evolved from a back-office function into a strategic partner by embedding payments into everyday workflows, automating revenue cycle tasks, and using AI to anticipate cash flow to help organizations free up resources that can be redirected to patient care. Click here to view the video or here to read her comments on our CEO Chat blog. Healthcare Fintech Forum We're excited to be hosting the first Healthcare Fintech Forum in Nashville from November 9-11, 2026. The inaugural event will bring together leaders across healthcare platforms, RCM services, banking, payments, capital markets and other areas to discuss the changing landscape for payments and financial services in healthcare. Our goal is to create a bespoke, high impact opportunity for like-minded individuals to learn, network, and ultimately grow their businesses. The primary theme this year is the emergence of embedded financial services, including patient payments, patient financing, and practice lending/ working capital, plus new models of B2B payments (payer-provider reimbursement). This year's event is capped at 80 people. If you have already received a personalized invitation and would like to register, click here. If not, to learn more and request your invitation click here. See you in Nashville this November! 2026 Sponsors ADDITIONAL RESOURCES Payments: The New Competitive Frontier for Healthcare Platforms. New white paper looking at data on medical, dental, and veterinary practice utilization of various payment and financing options, and interest in embedded finance. Conference List. Rolling twelve month look ahead at conferences and other events covering healthcare payments, revenue cycle, fintech and related areas. Updated through June 2027. FMP Blog. Thoughts from healthcare payments CEOs and investors on their right to win and goals for the year ahead, as well as data and perspectives on healthcare payments. 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, with some updates through August 2026, categorized by state, provider type and specialty. All of these resources can also be accessed at the FinMed Partners Insights page. Thank you for reading! If you enjoyed this newsletter, please forward to a friend or colleague. Share Newsletter 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 Unsubscribe Manage preferences |
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