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HARTFORDBUSINESS.COM | JUNE 1, 2026 21 Authored by: David Ference, Senior Vice President, Commercial Banking & Daniel Bishop, First Vice President, Commercial Banking at PeoplesBank W hen you enter the healthcare profession, the demands are relentless. Long hours, complex cases, emotional weight, and the never-ending responsibility of patient care. Running a healthcare practice asks just as much. With the rapid pace of technological shifts, complex reimbursement structures, intense workforce competition, and a persistent wave of industry consolidation, the business of healthcare is increasingly challenging. Take the significant investment in technology. From advanced diagnostics and telehealth infrastructure, to AI deployment in clinical and administrative workflows, we're seeing significant costs added to operating a healthcare organization. It's especially acute in Connecticut, where practices must satisfy both updated federal HIPAA requirements and the state's recently amended Data Privacy Act. Investing in technology is essential to the health and continued success of the business. Avoiding or continually delaying the investment can have negative impacts to the collection of payments, might cause reputational risk due to the utilization of outdated processes or equipment, and may pose a potential security risk to the practice. Hiring the right people has become significantly more challenging. Independent practices compete for clinical and administrative talent against large regional health systems at a time when Connecticut faces thousands of unfilled healthcare roles, a dynamic that pressures the entire operating model. Lower reimbursement rates compound that challenge by impacting margins and urging spending discipline. Navigating the New Economics of Healthcare: Five Financial Moves Every Local Practice Owner Should Consider Member FDIC 877.888.1388 bankatpeoples.com Against that backdrop is a flurry of consolidation. The transition of Manchester Memorial and Rockville General hospitals to Hartford HealthCare in late 2025 – an $86 million transaction that prompted new state legislation to streamline the approval process — illustrates how quickly the landscape can shift. Add to that interest from private equity seeking out physician and specialty practices. While some practitioners approaching retirement see a buyout offer as a clean exit and a strong return, others simply want to execute a smooth transition plan for their independent practice. Here are five steps to help navigate this environment effectively. 1. Understand your real cost of technology before you need it. Equipment, real estate, working capital and infrastructure financing are most effective when structured proactively, not in response to a crisis. Practices that model their three- to-five-year technology roadmap alongside their financing capacity make better decisions and negotiate better terms. Know what's coming before it arrives. 2. Treat working capital as a strategic asset, not a last resort. Cash flow in healthcare is structurally uneven. Reimbursements lag services rendered, private-pay collections require active management, and payroll doesn't wait. A well-structured working capital line of credit creates the operational buffer that allows a practice to grow intentionally rather than reactively. Practices that run lean on liquidity consistently underperform on growth. 3. Don't outsource your billing intelligence. Bringing greater in- house capacity to billing and collections, supported by technology and sound banking infrastructure, can improve recovery rates on private pay and reduce dependence on outsourced revenue cycle management. The margin recaptured often funds the investment required to make the shift. 4. If you're exploring M&A, know your value before anyone else does. Whether you are considering acquiring another practice or evaluating an exit, start with practice valuation for every intelligent conversation. Physicians who understand their enterprise value – and who have a banking partner capable of structuring acquisition financing – enter those conversations with leverage. Those who don't are at a structural disadvantage. 5. Build the advisory team before the inflection point. The practices navigating this environment most effectively share one common trait: they made the call to their banker, attorney, and accountant before the decision was urgent. Whether the conversation is about launching a new practice or opening a second location, having that advisory infrastructure in place before the moment of decision is what separates reactive outcomes from strategic ones. The economics of healthcare are shifting faster than most practice owners anticipated. The practitioners who treat the business side of medicine with the same rigor they bring to patient care are the ones building something that lasts.