Moving forward in a way that protects patient access and preserves your mission
The One Big Beautiful Bill Act (OBBBA) poses significant challenges to health systems, particularly in rural areas.
The legislation includes substantial reductions in Medicaid funding – estimated at more than $1 trillion over a decade – which could result in approximately 16 million individuals losing health coverage. Rural hospitals are especially vulnerable, as many are already operating at a loss. There will be an estimated $50.4 billion reduction in federal Medicaid spending on rural hospitals over 10 years, potentially leading to service cutbacks or closure.
Such outcomes threaten the mission of not-for-profit health systems dedicated to providing accessible care within their communities.
In light of these sweeping changes, health care leaders should act swiftly and strategically to safeguard the continuity of care – especially in underserved and rural regions where health systems are often a lifeline. Preserving access to care in the face of deep funding cuts may include deliberate operational, clinical, and strategic shifts.
To ensure they are continuing to deliver on their mission and provide quality care to the communities they serve, health care organizations should proactively seek ways to protect and preserve patient access.
Some strategies to consider include:
- Rethink traditional operating models and consider restructuring to drive greater efficiency and resilience. This may include streamlining and centralizing administrative and support services where possible to enable better cost control without compromising patient care.
- Evaluate how care is currently delivered and whether it aligns with the unique needs of the populations served. Conducting a thorough review of community needs can help determine the types of services required in each geographic area, ensuring resources are allocated effectively.
- Revisit population health strategies, including preventive care initiatives, wellness campaigns, and patient education and engagement efforts. Evaluating these dimensions can help promote long-term health, reduce demand for costly acute care, and guide smarter investment and resource allocation decisions.
- Analyze current telehealth capabilities to help bridge access gaps, particularly in rural regions where physical infrastructure may be strained.
- Leverage artificial intelligence (AI) to create efficiencies where possible, such as automating administrative workflows, optimizing staffing, supporting diagnostics, and enhancing patient outreach and engagement through data-driven insights.
These approaches can help organizations sustain their commitment to community health, even in times of fiscal uncertainty.
