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What the “One Big Beautiful Bill” Means for Healthcare Practices: A Financial Advisor’s Perspective 

Published on July 9, 2025

On July 4, 2025, the “One Big Beautiful Bill” was officially signed into law, marking one of the most significant tax overhauls in recent years. While much of the media coverage has focused on its political implications, healthcare professionals—especially practice owners—should be paying close attention to how this legislation could reshape their financial landscape.

As an accountant and advisor to healthcare providers, I believe this new law presents a timely opportunity to reassess your tax strategy, optimize your practice’s financial structure, and plan for long-term growth.

Six Key Tax Changes That Matter to You

Here are the six most impactful provisions of the new law for healthcare professionals: 

  1. Permanent Extension of 2017 Tax Cuts 
    The bill makes permanent the lower individual and business tax rates introduced under the Tax Cuts and Jobs Act (TCJA). This includes maintaining the 20% deduction for qualified business income (QBI) for pass-through entities like S corporations and partnerships—structures commonly used by healthcare practices. Additionally, the bill adjusts tax brackets for inflation, offering more predictability for long-term planning. 

  1. Tax-Free Overtime and Tip Income 
    Overtime pay and certain tip income are now exempt from federal income tax. This change is particularly relevant for practices with hourly staff or tipped services (e.g., med spas, dental assistants, or concierge care). It may allow you to offer more competitive compensation packages without increasing your payroll tax burden. 

  1. Expanded SALT Deduction 
    The cap on state and local tax (SALT) deductions has been temporarily raised from $10,000 to $40,000 for 2025, with inflation adjustments through 2029. This is especially beneficial for practice owners in high-tax states like California and New York. However, the deduction begins to phase down for taxpayers with modified adjusted gross income (MAGI) over $500,000. 

  1. Higher Estate and Gift Tax Exemption 
    The estate and gift tax exemption has been significantly increased, allowing practice owners to transfer more wealth to heirs or successors without triggering federal estate taxes. This is a strategic advantage for those considering succession planning, practice sales, or family trusts. 

  1. New Tax-Advantaged Savings Accounts for Children 
    The bill introduces flexible savings accounts for children that can be used for a wide range of expenses, including education, healthcare, and caregiving. These accounts offer tax-deferred growth and tax-free withdrawals for qualified expenses, making them a valuable tool for family-based financial planning. 

  1. 100% Bonus Depreciation Extended Through 2027 
    One of the most business-friendly provisions in the bill is the extension of 100% bonus depreciation through the end of 2027. This allows practice owners to immediately deduct the full cost of qualifying equipment, technology, and capital improvements in the year they are placed in service. Whether you're upgrading imaging equipment, renovating your office, or investing in new software, this provision can significantly reduce your taxable income and improve cash flow. 

What This Means for Healthcare Practices 

For healthcare practices, these changes offer both relief and responsibility. Here’s how: 

  • Cash Flow Flexibility: Lower tax rates and expanded deductions can free up cash that can be reinvested into the practice—whether that’s hiring, upgrading equipment, or expanding services. 

  • Payroll Planning: The tax-free overtime provision may allow small practices to offer more competitive compensation without increasing tax burdens, helping retain key staff in a tight labor market. 

  • Simplified Succession Planning: With a higher estate and gift tax exemption, small practice owners have more room to plan for transitions—whether passing the business to family or selling to a partner—without triggering significant tax consequences. 

  • Geographic Relief: Practices in high-tax states may benefit from the expanded SALT deduction, improving after-tax income for owners. 

  • Family-Centered Benefits: The new savings accounts for children could be a valuable tool for owner-operators balancing business and family financial goals. 

  • Capital Investment Incentives: The bonus depreciation extension makes it more financially viable for small practices to modernize their operations and stay competitive. 

The “One Big Beautiful Bill” is more than just a tax update—it’s a chance to rethink how your practice operates financially. These changes can unlock real opportunities, but only if they’re integrated thoughtfully into your broader strategy. That’s why we’ll be discussing these updates in detail during your upcoming tax planning appointments. If you haven’t scheduled yours yet, now is a great time to do so.

We’re here to help you navigate these changes with clarity and confidence, so you can focus on what you do best: caring for your patients and growing your practice.