How providers can prepare for the impact of the One Big Beautiful Bill

As the One Big Beautiful Bill Act ushers in new policy directions, healthcare organizations are entering a pivotal moment—one that calls for strategic modernization, operational agility, and deeper collaboration across the healthcare ecosystem. 

Rather than viewing this shift as a disruption, forward-thinking leaders are using it as a catalyst to reimagine their operating models, reconsider how systems are connected, and identify opportunities to better support patients.  

Here are five key actions for healthcare leaders navigating this evolving landscape: 

1. Help patients navigate shifts in coverage 

The law imposes stricter work requirements for Medicaid and Affordable Care Act (ACA) marketplace plans, narrows Medicaid eligibility requirements, and limits coverage for certain non-citizens. The bill is expected to lead to an additional 10 million uninsured people by 2034, according to an estimate by the Congressional Budget Office.   

As the law forces a change in eligibility and funding models over the next few years, healthcare organizations and their community partners will need to support patients through shifts in coverage, particularly those navigating Medicaid, Medicare, or ACA marketplace plans: 

Key actions 

• Proactively engage patients to verify eligibility and assist with plan transitions. 
• Encourage patients to evaluate their need for secondary coverage options, especially for Medicare populations. 
• Use digital tools to engage patients about changes in coverage and connect them to enrollment resources. 
• Support community workforce development to help patients retain coverage.  

2. Reimagine Medicaid, tribal, and rural health strategies 

OBBB also limits funding for Medicaid programs, in part by restricting taxes on providers and insurance companies that are a source for state Medicaid funding. As a result, provider organizations will need to rethink how they serve Medicaid populations—particularly in rural and at-risk areas. The law created a $50 billion Rural Health Transformation Program to support rural providers, but there are concerns it may not be enough to offset the impact of the cuts. 

Key actions 

• Seek out private funding, tribal and charity partners, and value-based payer arrangements that support continued growth in services for low-income and at-risk populations. 
• Develop a rural health strategy that includes community partnerships, telehealth services, remote patient monitoring, and creative staffing models that serve needs without adding to overhead costs.  
• Collaborate with tribal leaders to offer tailored support and public health messaging. 
• Use community health workers to assess needs carefully and facilitate effective allocation of limited funds. 
• Consider how changes in Medicaid eligibility and enrollment may indirectly impact status and payments under the 340B Drug Pricing Program.  

3. Prepare for the future by modernizing operations 

Leaders should consider where they can implement AI and automation quickly so that staff can be reallocated to handle the influx of uninsured and underinsured patients who will need help navigating coverage.  

In particular, finance executives should consider how their plans may change as a result of the bill’s key provisions and a major shift in payer mix. They must evaluate the potential financial impact, both short-term and long-term, and adjust their strategic vision accordingly. 

 Key actions 

• Use AI and predictive analytics to map out various scenarios and support financial decision-making.   
• Implement automated eligibility and benefits verification to free up staff. 
• Invest in enhanced clinical documentation improvement (CDI) and utilization management/review processes to maximize reimbursement. 
• Supplement onsite teams with off-shore/near-shore staff who can support an influx of patients who will need help navigating access and financial assistance. 

4. Consider the impact on M&A and partnerships  

The changing reimbursement landscape is likely to cause a shift in providers’ incentives for mergers, acquisitions, and partnerships. Strategy leaders should evaluate how current deals may be affected by the law’s changes and consider new acquisitions or partnerships to offset anticipated shifts in payer mix and patient demographics.  

Key actions 

• Map potential deals to specific operating model gaps and vulnerabilities under the new law, such as service lines, digital infrastructure, or expertise in serving at-risk populations. 
• Evaluate divestment options or turnaround strategies for assets that may become unsustainable as a result of the law. 
• For deals that have already closed, consider how post-M&A integration strategies may need to change as a result of the new law. 

5. Enhance the consumer experience to improve retention 

As coverage dynamics shift, patient retention becomes even more critical. Even as the bill tightens provider resources, many will continue to be at risk under value-based care plans that require them to keep patients engaged and in good health. Organizations that invest in convenience and strengthen their digital front door will win patients’ loyalty and deliver personalized care. 

Key actions 

• Expand self-service platforms for registration, access and payments to simplify access and make it easy for patients to manage their care.  
• Use consumer analytics to identify pain points and tailor engagement strategies. 
• Evaluate service line strategy to prioritize long-term outcomes and avoid losing patients to competitors. 

A new chapter in healthcare policy 

The One Big Beautiful Bill Act signals the next chapter in healthcare policy—one that will require leaders to realign resources, modernize operations, and get closer to the patients they serve. Organizations that act with urgency—planning thoughtfully and adapting swiftly—will be best positioned to lead in this new era.