As we usher in fall, TripleTree is reflecting on the year-to-date market trends that have framed 2025 and looking ahead to activity and opportunities in the coming months. Our 2025 TrendWatch blog outlined several key sectors where we expected to see outsized attention, investment, and potential further industry consolidation. Now, in this pulse check, we assess the market momentum we’ve seen thus far in 2025 and what that means heading into the final months of the year.

Industry Pulse Check

Announced M&A transaction volume in TripleTree’s core areas of Healthcare Technology and Services has continued to be relatively quiet in 2025, supporting a theme that has been omnipresent for the past few years. 1Q25 transaction volume in our core markets was down 8.8% year-over-year, down 13.6% from 1Q23, and down 43.8% from 1Q22, a quarter that reflected the conclusion of the Red Bull run that started in 2020.  

While this sobering market hasn’t exactly been user-friendly for many in the M&A business, TripleTree has consistently delivered exceptional results for its clients - at scale.  2024 marked the best year in TripleTree’s history, closing 25 transactions with an average Enterprise Value of $1.2B.  Our transaction trajectory has remained strong in 2025 with 26 transactions signed and/or closed as of September 2025.

The bottom line - TripleTree continues to deliver market leading valuations for our clients. We invite you to dive deeper into how our early-year trend insights are playing out well into 2025.

Investments Across AI & Tech Are Driving Disruption & Deals 

During the first half of 2025, as identified in the TrendWatch 2025 blog, we saw an increasing focus on organizations turning to technology investments and/or support from scaled, technology-enabled partners. This trend, particularly in the provider space, will continue to gain momentum and investment interest.

Investments in Artificial Intelligence (AI), Large Language Model (LLM), and automation technology will be a key focus area for incumbent and newly launched Revenue Cycle Management (RCM) businesses through year-end. They are critical to remain out front in an increasingly competitive ~$100B market, while managing costs and operational efficiencies as the entire industry seeks to win and better support healthcare providers as financial pressures continue to mount. 

Investors and buyers are increasingly scrutinizing AI risk and opportunity with respect to the RCM companies they are evaluating. Stakeholders know that AI will undoubtedly have an impact, but the extent to which AI transforms specific areas of RCM is still relatively uncertain - and as a result, the bar for risk appetite and deal making is increasingly high. The most near-term applicable areas we see right now in RCM where AI is being applied and having a disruptive impact are in the following:

• Denials Management (DM)
• Coding
• Clinical Documentation Improvement (CDI)

We’re tracking a multitude of use cases for AI in DM, particularly around the appeals workflow. Within Coding & CDI, AI can be a powerful force for creating compliant documentation in a more prospective (versus retrospective fashion). These examples, among others, are providing significant momentum that is driving efficiency and improved accuracy in the sector. 

Companies like CorroHealth, RevSpring, and Omega are examples of larger organizations actively deploying AI and automation technology to drive efficiencies and better accuracy into their organizations. 

MDAudit is actioning data through their software and investing in innovative ways to leverage AI and other technologies to drive further benefit and ROI for their hospital customers.

We expect the pace of transformation to accelerate in RCM as more capital pours into these businesses and the incumbents accelerate their investments in technology, new products, offshore infrastructure, and M&A. End-to-end and broader, modular focused vendors with scale and reputable customer bases will be the best positioned to expand and further consolidate the market.  The adoption curve for AI in particular is exponential, not linear, which will intensify as these models gain more traction and access to large healthcare providers and RCM data sets.

As we look to the remainder of 2025, we anticipate a number of actionable opportunities in this segment. Investors will see continued activity at scale, with perhaps some of the largest names in RCM taking on new investors or going public. 

We also expect to see a number of businesses across RCM categories in the core to upper middle market (e.g. EBITDA $20 - $100M+) explore the market, including businesses that are: 

• focused on specialty areas within the physician and ambulatory RCM segment (e.g. anesthesiology, radiology or behavioral health)
• addressing a broad capability set across the health system end-market, and 
• designed with more specialized, tech-enabled RCM capabilities, focused on a particular point solution

An Optimistic Tone for Multi-Site Healthcare Opportunities

The multi-site healthcare sector is seeing several "green shoots" that are encouraging for deal activity in the back half of this year and into early 2026.

With the final round of government reimbursement cuts landing earlier this year, there is significant political pressure on Congress to improve reimbursement for physicians. This will likely create some upside on rates, which has long been a challenge for providers. We’re seeing progress in areas like this recent physician pay increase proposal from the Centers for Medicare & Medicaid Services (CMS). 

Additionally, we’re noting some trends that will positively affect investment activity in both the short and long-term. 

• Commercial reimbursement rates are improving in select specialties, leading to increased deal activity
• Wage inflation has stalled, paralleled by an increase in clarity in Federal Trade Commission (FTC) and state regulatory environments

With healthcare stakeholders (providers?) seeing patient demand becoming more consistent and predictable coming out of the COVID-19 pandemic, strategic buyers are increasingly active in sell-side processes for scaled Physician Practice Management (PPM) assets. 

The fundamental rationale for building provider platforms (or PPM) remains as relevant as ever:

• Delivering care to patients is getting more complex, not less
• Small physician groups are less equipped to deal with the various headwinds and complexities of our healthcare system
• Changing physician preference means earlier-career physicians are less interested, and less financially capable given their med school debt load, of "being their own boss" and starting their own practices
• In a world where there is not enough clinical supply (physicians) to meet clinical demand (patients), having a business with scale is one of the few ways providers drive efficiency, even if modest, to see more patients and close that clinical gap

The challenges of the past several years have acutely highlighted the benefits to physicians that come with scale and investment, and things aren’t slowing down. With more clarity and demonstrated impact across many dimensions of the healthcare ecosystem, we’re optimistic about the upward market momentum from the first half of the year.

TripleTree's recent work across the PPM spectrum - dental, cardiovascular, MSK, dermatology, surgicalist - gives us a unique level of insight into how investors and acquirers are thinking about PPM and multi-site healthcare.  

At its foundation, sellers need to focus on four fundamental questions as they assess opportunities:

Sound Solutions Underpin Stability in the Managed Care Sector

It's been a bumpy first half of the year for the managed care sector, with multiple health plans reducing or withdrawing guidance as they work through regulatory changes, increasing Medical Loss Ratios (MLRs), tighter margins, and reduced federal support for Medicaid and Affordable Care Act (ACA) programs. 

That said, the sector is expected to remain stable with continued investments in infrastructure and solutions that are helping to drive value-based care delivery and manage margins in critical ways:

	Administrative Efficiencies  More companies are focused on administrative efficiencies and often start with enhancements to their core adjudication system, followed by the build-out of integrated functions that leverage data across clinical and administrative workflow. TripleTree Served as Lead Advisor to Bain Capital on its Strategic Investment in HealthEdge. TripleTree advised Cotiviti on its Acquisition of Edifecs.
	Revenue Management CMS-HCC Version 28 (v28), the latest iteration of the Centers for Medicare & Medicaid Services' (CMS) Hierarchical Condition Category risk adjustment model, has left little room for error and increased the stakes in both Medicare Advantage (MA) and Affordable Care Act (ACA) markets. Best-in-class platforms that can ensure coding accuracy and facilitate tighter payer-provider collaboration will continue to attract investment. TripleTree advised Advantmed on its recapitalization by Webster Equity Partners.
	Cost Containment  The market is seeing a new wave of innovation across payment integrity functions that leverage tech/AI to transform the payment process. Trends include implementing new case management (CM), denials management (DM), and utilization management (UM) functions, which facilitate novel opportunities to manage spend. TripleTree advises ProgenyHealth on its Strategic Growth Investment by Cressey & Company and Sunstone Partners.
	Shift to Value-Based Care (VBC) With an aim to enable wide-scale VBC, health plans are requiring new sources of data and broader provider engagement. The introduction of new data strategies that drive predictive insights are proving to better manage risk, care, and quality. TripleTree advised Nordic Capital on its Acquisition of Arcadia.

TripleTree entered the year thinking that 2025 would bring a stabilizing M&A environment, and we have seen significant M&A across many of the areas we highlighted in our 2025 Trendwatch blog, including healthcare technology and specialized healthcare services. Inorganic growth conversations with strategic acquirers have accelerated in the last several months, and this foretells an even stronger second half of the year for strategic M&A. Our focus remains on the technology and services areas, where we will be paying particular attention to more budget clarity in government funded programs around Medicare and Medicaid. This greater insight will allow strategics with large exposure to those programs to execute on growth plans with new economic clarity.

TripleTree looks forward to continued interactions with strategic acquirers focused on accelerating their inorganic strategies with upcoming opportunities to interact in person at the following conferences and events.

INVEST Behavioral Health (Oct 2025)

HLTH 2025 Vegas (Oct 2025) 

SIIA National Conference (Oct 2025)