Well that was fun, wasn't it? We assume we're among many who were expecting that it might take days to declare a new U.S. president. Instead, the drama turns out to be over control of the House of Representatives, and how many judges the currently Democrat-controlled Senate can confirm before the new Congress begins in January. With the new administration taking shape quickly, we thought it would be useful to share some perspectives on how a second-term President Trump might impact healthcare, banking, credit cards and payments. Plus deal news, AI and a CEO Chat with Matt Sydney from Beanstalk Benefits. Read on for all the details!
DEAL NEWS
Global Payments sells AdvancedMD to Francisco Partners
As the EHR industry continues to mature in both the acute and ambulatory markets, we see vendors consolidating, gaining new ownership, and looking to the public and private capital markets for different reasons. NextGen went private last year, athenahealth is likely to go public at some point, and Veradigm is for sale (see below). So we weren't surprised to see another EHR deal materialize.
Global Payments' sale of AdvancedMD was revealed in an SEC filing in late October. Global Payments had been rumored to be shopping the EHR company all year. Its 8-K filing indicated that Francisco Partners will pay $1.125 billion for AdvancedMD. Global Payments CEO Cameron Bready said that AdvancedMD was "not the best strategic fit" during the company's earnings call at the end of October. AdvancedMD is round tripping back to Francisco Partners, which first acquired the company in 2008 before selling it to ADP in 2011.
For the second time this year, Los Angeles-based Sunbit has secured a new debt warehouse facility to support its growth in new markets, including healthcare where it has become the second largest provider of dental financing. In early November, the company closed on a $355 million debt facility led by J.P. Morgan, Mizuho Bank and Waterfall Asset Management. This follows on the $310 million raised earlier this year with Citi and Ares Management. For more on Sunbit's approach to healthcare, read our CEO Chat from last month.
Veradigm (formerly Allscripts), which has previously expressed interest in finding a buyer, is reportedly being pursued by multiple suitors. On November 10, Seeking Alpha wrote that McKesson, Oracle and investor Thoma Bravo are finalists to buy Veradigm. (Thoma Bravo took EHR company NextGen private in a $1.8 billion deal in 2023.) Previous news has suggested that Veradigm's price tag could exceed the company's $1 billion market value, which Seeking Alpha mentioned as well, due to the expectation of lower antitrust risk from the incoming Trump administration.
Oracle Health, the former Cerner, has announced plans to introduce a new EHR next year. According to Seema Verma, EVP and general manager of Oracle Health and Life Sciences, the new system shouldn't really be called an EHR. She said during Oracle's Health Summit at the end of October, "It’s a misnomer to even call it an EHR, because it’s no longer a record-keeping system, but instead it’s a dynamic, evolving system of intelligence that spurs action to ensure better patient outcomes."
Some industry veterans wonder how Oracle will release a fully formed new piece of software so quickly, especially in a segment as complex as acute patient care. KLAS reported that Oracle experienced a significant net loss of hospitals in 2023, with Epic the beneficiary as Epic continues to increase its share of the hospital market. A recent HISTalk poll suggested that Oracle's biggest challenge in launching this new software will be convincing current legacy Cerner customers to switch to it, instead of to Epic.
What does the future hold for healthcare and payments in a second Trump Administration?
By now we know that Donald Trump handily won the U.S. presidency. The Senate will be in Republican control. While all house races have not been called, as of this writing Republicans have 216 house seats and look set to control that chamber with a slim majority. What does this mean for healthcare overall? Banking, and credit card issuers? What about payments, more broadly? Crypto? We have summarized here some early perspectives on all these questions.
Healthcare
Ever rising U.S. healthcare costs will continue to put strain on patients, employers and workers no matter who is president. Overall health spending has soared - up 50% in the last decade to a projected $5 trillion in 2024 - and is expected to continue to outpace GDP growth. Last time around, Republicans chipped away at but failed to repeal the Affordable Care Act (click here for a good analysis of healthcare policy during the first Trump administration).
Key areas to watch include Medicare Advantage, which Republicans favor but which faces scrutiny over overpayments, and Medicaid, which may face cuts to fund tax cuts. An expanded "site-neutral" payment system would pose a threat to hospitals. For workers getting their healthcare coverage from exchanges, many would drop those policies if Republicans allow the ACA's expanded premium subsidies to expire. For workers getting coverage from employers, healthcare costs will continue to rise no matter who is in the White House.
Finally, while ongoing FTC scrutiny of the big PBM players has bipartisan support, a Trump administration is likely to take a softer approach in general to antitrust enforcement. Trump’s stance has generally favored deregulation, which should benefit big payers and hospital companies, and healthcare M&A in general.
Banking Dive printed a summary of thoughts from six U.S. bank executives regarding a new Trump administration. They cover the impact of pro-growth policies on bringing people back to the office, and potential upside for commercial real estate. The impact on capital requirements. The overall regulatory environment (everyone expects it to be lighter), including the CFPB. The need to continue to focus on operations and execution, despite the political noise. And the potential impact on consumer investments in a pro-growth environment. Hear from:
It is unclear whether Republicans will want to keep some measures popularized under President Biden’s CFPB. Card issuers have increasingly relied on APR margins rather than fees, and might ultimately be willing to accept some fee restrictions. For now, issuing banks have fought tooth and nail to prevent lowering the cap on credit card late fees to $8. Bank opposition combined with a new CFPB head who will likely prioritize policing markets over broad regulation through rule making means that most rules completed by the current CFPB are in jeopardy.
Interestingly, all the pending litigation against proposed CFPB rules will complicate efforts to roll them back and any changes to final rules will still have to be done through the public notice and comment process. One area of progress that is likely to survive is the CFPB’s open banking rule, which Republicans have not challenged. There’s generally broad consensus when it comes to protecting consumer data privacy, and giving consumers more ability to move accounts between banks.
The DOJ lawsuit against Visa for monopolizing the debit card market is likely to continue. And there’s broad bipartisan support for pending legislation called the Credit Card Competition Act to give merchants more choice regarding card networks. (This bill also has the potential to severely curb if not eliminate credit card rewards.)
The private crypto market has reacted enthusiastically to President Trump’s election, on the assumption of a more supportive regulatory environment. Elon Musk is a huge crypto supporter, and the Trump family itself has begun investing in crypto. As an indicator of market bullishness regarding a favorable climate for crypto, bitcoin prices are hitting all-time highs (near $90,000), up 30% since polls closed on November 5th.
The same is not true for central bank digital currency (CBDC) under Trump. CBDCs face resistance from Republicans, who view them as potential surveillance tools. President Trump also has no interest in handing over more power to the Federal Reserve. Lacking strong use cases, banks are concerned that CBDCs might reduce their deposit base. Private stablecoins and deposit tokens may emerge instead, offering CBDC-like benefits without direct government control especially for cross-border payments.
Click here to read our latest CEO Chat with Matthew Sydney, CEO of Philadelphia-based Beanstalk Benefits.
AI IN HEALTHCARE
Why a prominent health tech VC keeps adjusting how it thinks about AI in healthcare. Lynne Chou O’Keefe, Founder and Managing Partner at Define Ventures, explained to a reporter at HLTH how her firm approaches AI given that "the dynamics of AI in health tech are changing all the time". Define Ventures most recently raised $460 million to invest in early-stage health tech companies. (Endpoints News)
WHAT WE'RE READING
Detroit to become largest city in U.S. to accept cryptocurrency for taxes. In 2025, Detroiters will have the option to pay their taxes and other city fees with cryptocurrency, making Detroit the largest city in the U.S. to accept cryptocurrency for taxes. Payments will be made through a secure platform and managed by PayPal. (CBS News)
Deal Tracker. Regularly updated list of healthcare payments related transactions since November 2023.
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.
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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.
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