The new One Big Beautiful Bill Act (OBBBA) just passed, and it’s going to change the way many healthcare practice owners think about taxes. In our previous article, we explored how the OBBBA is expected to impact Medicare and Medicaid reimbursement. In this piece, we’re focusing specifically on the tax implications of the bill for healthcare businesses.
If you run a small-to-medium-sized healthcare practice this bill could directly impact how much you owe and how much you keep in your pocket.
We know you don’t have time to comb through hundreds of pages of tax code. So we broke it down into simple terms, with examples, so you can quickly understand what’s changing and how it could benefit your business.
More Predictable Tax Savings with QBI
First up: good news if your practice is an S Corporation or LLC.
The QBI (Qualified Business Income) deduction, which lets you write off 20% of your business profits, was set to expire in 2025. The new law makes it permanent.
What does this mean in real life? If your practice makes $300,000 in profits, you only pay taxes on $240,000. That’s money back in your pocket every single year, not just for the next year or two, but indefinitely.
For most small healthcare practices, this makes it even more worthwhile to keep your pass-through structure and continue paying yourself in a tax-efficient way.
Big Purchases Now Bring Bigger Tax Breaks
Thinking about upgrading equipment or renovating your clinic? This bill brings back 100% bonus depreciation. That means you can write off the entire cost of qualifying purchases in the same year you buy them - whether it’s therapy equipment, laptops, or build-outs.
To be clear, this applies to assets with a MACRS recovery period of 20 years or less. That includes most common practice purchases like therapy equipment, computers, office furniture, and non-structural office improvements. It doesn’t apply to land, buildings, or other property with longer recovery periods.
Instead of spreading out tax deductions over several years, you get the full benefit immediately. For example, if you spend $20,000 on therapy equipment this year, you can knock $20,000 off your taxable income right away.
And there’s more. Section 179 expensing also got a major upgrade. The amount you can expense in one year has doubled: jumping from about $1.2 million to $2.5 million. That’s especially useful if you’re making larger investments like sensory rooms, new vehicles for community-based services, or major office renovations.
Both options help you lower your tax bill right when you make big investments, giving you more breathing room to reinvest and grow.
Bad Years? You Can Use Those Losses to Your Advantage
Some years are tougher than others: whether it’s expanding into new markets, adding locations, or dealing with delayed insurance payouts. The OBBBA makes the Excess Business Loss deduction permanent. This allows you to use business losses to offset other personal income, like your spouse’s salary, rental property profits, or investment gains.
For example, let’s say your practice had a tough year and posted a $100,000 loss. But your spouse earned $150,000 at their hospital job. With this rule, you can apply your practice’s loss to reduce your household taxable income from $150,000 to $50,000. That’s a big tax saving during a down year.
But there are caps to keep in mind. In 2025, the maximum deductible loss is $580,000 if you’re married or $290,000 if you’re single. Anything beyond that rolls into future years as a Net Operating Loss.
This means if you have a major loss - say from expanding a clinic - you can wipe out taxes on your household income up to those limits in the same year, and carry forward the rest.
This rule gives practice owners a much-needed safety net during expansion phases, slower seasons, or unexpected downturns.
Bigger Potential Gains if You’re Eyeing a Sale
Thinking about selling your practice someday? The One Big Beautiful Bill could help you keep more of the sale proceeds.
Under the new rules, if you convert your practice to a C Corporation and meet certain requirements, you can exclude up to $15 million in capital gains from federal taxes when you eventually sell. That’s up from the previous $10 million cap.
It’s not for everyone, but if you’re planning to sell in 5-10 years, this strategy could save you millions. Just know, it works best if you make the switch to a C Corp early and stick to it long enough to meet the holding period rules.
If you’re even starting to think about selling, first and foremost, read our guide on what every practice owner should know before selling.
New Ways to Support Your Team (and Pay Less Taxes)
Hiring and retaining good people is tough, especially in healthcare.
Many of our Flychain customers, particularly in behavioral health and home-based care like home health and home care, consistently tell us that employee churn is one of their biggest challenges. Clinicians, care coordinators, and admin staff are in short supply, and turnover can be costly.
That’s why we’ve been highlighting this part of OBBBA to a lot of our Flychain customers.
The new law expands several tax-deductible employee benefits, including things like student loan repayment programs and dependent care assistance. These are meaningful benefits that can help you stand out as an employer, without adding a huge financial burden to your practice.
For example, if you decide to offer student loan repayment support to your team, it’s tax-deductible for your practice. You get a tax break, and your team gets help with something that really matters to them. In many cases, owners can participate in these programs too.
For practices struggling with hiring and retention, this is a smart way to build loyalty while reducing your tax bill. We also recorded a podcast on HR and Financial Essentials for Healthcare Providers in 2025. Check it out for more tips on building a stronger, more resilient team.
Personal Tax Perks You Don’t Want to Miss
The One Big Beautiful Bill also brings some helpful personal tax changes. These are worth knowing, especially since many practice owners use business income to cover both personal and business expenses.
- First, the SALT (State and Local Tax) deduction cap is getting a big lift. It’s going from $10,000 to $40,000 per year through 2029. This is especially helpful for practice owners in high-tax states like California, New York, or New Jersey.
- Health Savings Accounts (HSAs) are also getting expanded access. These are a great way to save for healthcare expenses while taking advantage of HSA tax benefits that can lower your overall tax bill.
- The Child Tax Credit is also increasing, now sitting at $2,200 per child under 17. That’s a nice extra savings if you have kids, particularly useful if you’re already paying for childcare, education, or therapies.
- If you’re nearing retirement age - or supporting older family members - there’s another boost. The Senior Standard Deduction is expanding. For those 65 and older, the extra standard deduction jumps to $6,000 (or $12,000 for couples). This makes it easier to lower your personal taxes even if you don’t itemize deductions.
- Another addition is a new children’s savings account. It comes with a $1,000 government contribution for qualifying families. You may hear people calling it the “Trump Account.” However, here’s a quick heads-up: this is a brand-new program. And with new programs, there are often details that get worked out later. Rules can change, and guidance can be a little murky at first.
However, we always recommend speaking with a tax advisor or financial planner before jumping into any new benefits. Some options, like HSA tax benefits, have a long track record and clear tax advantages. Others, like the children’s savings account, may have more kinks to work out.
A quick chat with a professional can help you decide which benefits are smart to use right away, and which ones are better to watch and wait.
There’s Money to Be Saved with One Big Beautiful Bill
To sum it up, the One Big Beautiful Bill Act gives practice owners more ways to save money and build long-term wealth.
With more predictable deductions, faster write-offs for equipment, better protection during down years, smarter exit planning options, and expanded benefits for both your team and family - it’s a great time to revisit your tax strategy.
At Flychain, we help healthcare providers stay on top of their financial health. Whether it’s updating your books or partnering with tax strategy experts like Uprise, we’re here to help you keep more of your hard-earned money. Beyond tax planning support, Uprise also offers tax filing for healthcare practices and works with many of our Flychain customers.
We’ll be going even deeper into these changes in our upcoming webinar with Uprise. Want to join? Just email us at info@flychain.us if you’d like to attend!
And if you’re already with Flychain, reach out anytime to get a financial review tailored to these new rules. Flychain is here to help you financially thrive.
Contact the Flychain team here for a free consultation - no strings attached!