No Result
View All Result
SUBMIT YOUR ARTICLES
  • Login
Thursday, October 23, 2025
TheAdviserMagazine.com
  • Home
  • Financial Planning
    • Financial Planning
    • Personal Finance
  • Market Research
    • Business
    • Investing
    • Money
    • Economy
    • Markets
    • Stocks
    • Trading
  • 401k Plans
  • College
  • IRS & Taxes
  • Estate Plans
  • Social Security
  • Medicare
  • Legal
  • Home
  • Financial Planning
    • Financial Planning
    • Personal Finance
  • Market Research
    • Business
    • Investing
    • Money
    • Economy
    • Markets
    • Stocks
    • Trading
  • 401k Plans
  • College
  • IRS & Taxes
  • Estate Plans
  • Social Security
  • Medicare
  • Legal
No Result
View All Result
TheAdviserMagazine.com
No Result
View All Result
Home Market Research Market Analysis

What Healthcare Leaders Need to Know

by TheAdviserMagazine
4 months ago
in Market Analysis
Reading Time: 4 mins read
A A
What Healthcare Leaders Need to Know
Share on FacebookShare on TwitterShare on LInkedIn


The One Big Beautiful Bill Act will reshape healthcare for years to come. While it presents challenges, especially for vulnerable populations, it also opens the door to efficiency and new market opportunities. Healthcare organizations (HCOs) must act now to develop strategies that protect their business and their customers.

Sweeping changes for the healthcare industry

As a result of the legislation, an additional 11.8 million individuals are expected to become uninsured by 2034. The law significantly changes healthcare access and funding, via:

ACA subsidy rollbacks. The expiration of enhanced premium tax credits, along with changes to plan criteria for cost-sharing reductions (CSR), will result in fewer covered individuals. The initial CBO projection estimates 300,000 people will lose coverage.
Medicaid restrictions. Medicaid’s new work requirements and exclusions for certain adults along with shortening the redetermination period to six months will likely increase churn and reduce enrollment. CBO estimates expect at least 10 million fewer individuals will be covered by Medicaid by 2034.
Provider tax limitations leave gaps on Medicaid funding. States that rely heavily on these provider taxes for will face budget gaps that could lead to reduced provider reimbursement rates, narrowed eligibility, fewer covered services, lower provider participation, and limited access for enrollees. For example, New York expected to generate $1.5 billion annually from the tax. However, under the new law, this tax will be eliminated by January 1, 2026.
The addition of a Rural Health Fund. The Senate added a Rural Hospital Relief Fund (RHRF) to soften the impact of restrictions on provider taxes for states that did not expand Medicaid. Nearly 800 rural U.S. hospitals are at risk of closure due to financial problems, with about 40% of those hospitals at immediate risk of closure. The fund will supply some mitigation but not enough to stem the spread of medical deserts for rural America.
Dual eligibles will continue to face complex enrollment processes. The Medicare Savings Programs will face delayed implementation of the final rule, which would streamline Medicaid and Medicare determinations and enrollment, and under which Medicaid can cover the cost of Medicare premiums/cost for low-income seniors and individuals with disabilities. This delay may reduce member enrollment for health insurers offering Dual Eligible Special Needs Plans and lead to members avoiding or delaying care and medication due to lack of affordability.
Expansion of HSAs and related provisions. The legislation expands access to Health Savings Accounts by classifying any ACA marketplace bronze or catastrophic plan as a high-deductible health plan (HDHP). The law allows HDHPs to cover telehealth services on a pre-deductible basis, reclassifying them as preventive care. Additionally, HDHP enrollees may now participate in Direct Primary Care Service arrangements. These changes aim to improve access to affordable preventive care and align with the broader Make America Healthy Again policy agenda.
ICHRA becomes CHOICE. The Individual Coverage Health Reimbursement Arrangement (ICHRA) was based on regulatory guidance. Formally establishing The Custom Health Option and Individual Care Expense (CHOICE) arrangement in federal law provides long-term stability for employers and employees using defined contribution health models.

What to watch for as the industry adapts

The legislation is reshaping the healthcare industry, introducing significant financial and operational changes for providers, insurers, PBMs, pharmacies, and employers, such as:

Providers’ uncompensated care costs will increase. Financial pressures may accelerate industry consolidation and exacerbate medical deserts. While the law allows rural hospitals to convert to Rural Emergency Hospitals, urban areas face significant spread of medical deserts already, and all geographies should prepare for shortages.
Health insurers will feel pain in multiple LOBs. The rollback of enhanced ACA premium subsidies and changes to CSR eligibility could reduce enrollment in individual market plans, particularly among low- and moderate-income consumers. Stricter Medicaid eligibility verification and redetermination rules may increase churn, affecting managed care organizations. At the same time, CHOICE will likely encourage more employers to transition their employees to individual market coverage, leading to more complex enrollment patterns and evolving plan requirements.
PBMs get a [temporary] reprieve. For now, PBMs walk away mostly unscathed but shouldn’t wait until they are forced to transform their business. A ban on spread pricing will require PBMs to disclose actual drug costs, limiting profits from opaque pricing but reducing price volatility. This may lead to PBMs pivoting to value-based, cost-plus, or pass-through pricing models.
Pharmacies gain indirect support for underserved areas. The new RHRF may indirectly benefit rural pharmacies by stabilizing healthcare infrastructure in underserved areas. This creates the opportunity for rural and independent pharmacies to explore partnerships with hospitals and clinics that stand to receive funding through the RHRF.
Employers gain flexibility in the face of rising medical costs. Reduced ACA subsidies could make coverage less affordable for low-income workers. Under CHOICE, employers can offer defined contribution models, and small businesses may now provide both CHOICE and traditional group health plans to the same class of employees—a flexibility not permitted under ICHRA. More employers are expected to experiment with CHOICE and other new models to combat rising medical costs.

Get ahead of the changes

Healthcare consumers are looking for stability and clarity, and so far, have felt little impact from policy change. While Forrester’s April 2025 Consumer Pulse Survey found that 34% of US online adults reported feeling little to no impact from changes in health policy, data from June’s survey shows that number increasing to 42%. Roughly 1 in 5 US online adults also say they don’t know if recent changes to health policy make it easier or harder to access healthcare services. Consumers impacted by the new law’s changes run the risk of being blindsided.

 

HCOs can respond to federal budget changes by prioritizing empathy, clarity, education, resources, and technology. They should validate concerns, simplify complex policies, and proactively educate communities to reduce confusion and build trust. Leveraging clear resources and adopting resilient, intuitive technologies will enhance care access and improve patient experience.

Let’s dig deeper into the changes and volatility unfolding in the healthcare market.  Forrester clients can schedule a Guidance Session and check out our research on How to Thrive Through Volatility. Not a client? Let’s talk about how we can help.



Source link

Tags: healthcareleaders
ShareTweetShare
Previous Post

US Could Mine Bitcoin Through Public-Private Deal: White House Exec

Next Post

Trump signs One Big Beautiful Bill: What that means for your money

Related Posts

edit post
10 Bargain Dividend Stocks Ready to Shine in a Falling-Interest-Rate Environment

10 Bargain Dividend Stocks Ready to Shine in a Falling-Interest-Rate Environment

by TheAdviserMagazine
October 23, 2025
0

With a Fed rate cut all but certain, dividend stocks are back in focus. Lower yields on cash and bonds...

edit post
Predictions 2026: Automation At The Crossroads

Predictions 2026: Automation At The Crossroads

by TheAdviserMagazine
October 23, 2025
0

The race towards cognitive automation is well underway. For years, deterministic automation has been the backbone of reliability and compliance....

edit post
3 High-Growth Tech Stocks Poised to Crush Earnings and Fuel Further Rallies

3 High-Growth Tech Stocks Poised to Crush Earnings and Fuel Further Rallies

by TheAdviserMagazine
October 22, 2025
0

As the tech sector continues its relentless climb, investors are eyeing select companies with upcoming earnings reports that could ignite...

edit post
Interventional Ultrasound Market Analysis: Key Drivers and Challenges

Interventional Ultrasound Market Analysis: Key Drivers and Challenges

by TheAdviserMagazine
October 22, 2025
0

The Interventional Ultrasound Market is witnessing rapid growth, driven by the rising demand for minimally invasive procedures and the increasing...

edit post
Rebate From Supplier

Rebate From Supplier

by TheAdviserMagazine
October 22, 2025
0

Computer Market Research (CMR): The Ultimate Channel Management Compendium PART 1 Table of Contents for Part 1 Introduction to Channel...

edit post
Netflix Q3, 2025 Earnings: It’s All About Focus

Netflix Q3, 2025 Earnings: It’s All About Focus

by TheAdviserMagazine
October 21, 2025
0

Netflix is poised for a strong year-end finish, backed by another quarter of standout performance. Quality content at a fair...

Next Post
edit post
Trump signs One Big Beautiful Bill: What that means for your money

Trump signs One Big Beautiful Bill: What that means for your money

edit post
Texas floods: At least 13 dead and more than 20 children missing

Texas floods: At least 13 dead and more than 20 children missing

  • Trending
  • Comments
  • Latest
edit post
77-year-old popular furniture retailer closes store locations

77-year-old popular furniture retailer closes store locations

October 18, 2025
edit post
Pennsylvania House of Representatives Rejects Update to Child Custody Laws

Pennsylvania House of Representatives Rejects Update to Child Custody Laws

October 7, 2025
edit post
What to Do When a Loved One Dies in North Carolina

What to Do When a Loved One Dies in North Carolina

October 8, 2025
edit post
Probate vs. Non-Probate Assets: What’s the Difference?

Probate vs. Non-Probate Assets: What’s the Difference?

October 17, 2025
edit post
California Attorney Pleads Guilty For Role In 2M Ponzi Scheme

California Attorney Pleads Guilty For Role In $912M Ponzi Scheme

October 15, 2025
edit post
Baby Boomers Are Flocking to This Florida Town — but Not for the Weather

Baby Boomers Are Flocking to This Florida Town — but Not for the Weather

October 9, 2025
edit post
One Nation, One Workforce: Govt plans integrated system to ensure social-security portability for all workers

One Nation, One Workforce: Govt plans integrated system to ensure social-security portability for all workers

0
edit post
How the IBX biosimilar strategy lowers specialty drug costs

How the IBX biosimilar strategy lowers specialty drug costs

0
edit post
Why Planning Is So Hard

Why Planning Is So Hard

0
edit post
Reward and Retribution Is the New U.S. Policy for Latin America

Reward and Retribution Is the New U.S. Policy for Latin America

0
edit post
Fed To Join Payments Revolution, Bring Crypto In From the Fringes

Fed To Join Payments Revolution, Bring Crypto In From the Fringes

0
edit post
‘Cash, precious metals, crypto’ is new norm for peak stock market risk

‘Cash, precious metals, crypto’ is new norm for peak stock market risk

0
edit post
Tesla’s weak earnings show how the ‘Musk Magic’ Premium is inflating its share price

Tesla’s weak earnings show how the ‘Musk Magic’ Premium is inflating its share price

October 23, 2025
edit post
‘Cash, precious metals, crypto’ is new norm for peak stock market risk

‘Cash, precious metals, crypto’ is new norm for peak stock market risk

October 23, 2025
edit post
One Nation, One Workforce: Govt plans integrated system to ensure social-security portability for all workers

One Nation, One Workforce: Govt plans integrated system to ensure social-security portability for all workers

October 23, 2025
edit post
Reward and Retribution Is the New U.S. Policy for Latin America

Reward and Retribution Is the New U.S. Policy for Latin America

October 23, 2025
edit post
Glassnode identifies concentrated Bitcoin selling amid market consolidation

Glassnode identifies concentrated Bitcoin selling amid market consolidation

October 23, 2025
edit post
20 of the Best Job Search Sites for Finding Work

20 of the Best Job Search Sites for Finding Work

October 23, 2025
The Adviser Magazine

The first and only national digital and print magazine that connects individuals, families, and businesses to Fee-Only financial advisers, accountants, attorneys and college guidance counselors.

CATEGORIES

  • 401k Plans
  • Business
  • College
  • Cryptocurrency
  • Economy
  • Estate Plans
  • Financial Planning
  • Investing
  • IRS & Taxes
  • Legal
  • Market Analysis
  • Markets
  • Medicare
  • Money
  • Personal Finance
  • Social Security
  • Startups
  • Stock Market
  • Trading

LATEST UPDATES

  • Tesla’s weak earnings show how the ‘Musk Magic’ Premium is inflating its share price
  • ‘Cash, precious metals, crypto’ is new norm for peak stock market risk
  • One Nation, One Workforce: Govt plans integrated system to ensure social-security portability for all workers
  • Our Great Privacy Policy
  • Terms of Use, Legal Notices & Disclosures
  • Contact us
  • About Us

© Copyright 2024 All Rights Reserved
See articles for original source and related links to external sites.

Welcome Back!

Login to your account below

Forgotten Password?

Retrieve your password

Please enter your username or email address to reset your password.

Log In
No Result
View All Result
  • Home
  • Financial Planning
    • Financial Planning
    • Personal Finance
  • Market Research
    • Business
    • Investing
    • Money
    • Economy
    • Markets
    • Stocks
    • Trading
  • 401k Plans
  • College
  • IRS & Taxes
  • Estate Plans
  • Social Security
  • Medicare
  • Legal

© Copyright 2024 All Rights Reserved
See articles for original source and related links to external sites.