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Healthcare leaders are laser-focused on understanding how the future financial trajectory of their organizations might take shape post-OBBB—and what they can do to guide their organizations to long-term sustainability.

With an estimated $1 trillion in healthcare-related spending reductions, the One Big Beautiful Bill could significantly disrupt the U.S. healthcare system. Flourishing in the face of uncertainty will require focus on four imperatives: margin transformation, care delivery realignment, structural resilience and technological enablement.

Not-for-profit hospital and health system leaders are currently monitoring a flurry of rapidly evolving potential changes to state and federal policy with significant, long-term financial ramifications for their organizations.

With extension of the 2017 tax cuts identified as a key priority for the incoming Trump administration, offsetting expense actions will be needed to avoid increasing the federal deficit. Hospital leaders should be prepared for potential cuts to both the Medicaid program and the enhanced ACA subsidies enacted in 2021.