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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.

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.

Fierce Healthcare's Dave Muoio chats with Lisa Goldstein, senior vice president at the consulting firm Kaufman Hall, about what hospital leaders will need to focus on in the new year.

For more than a decade, hospitals, payers, and other healthcare stakeholders have experimented with moving healthcare payment from fee-for-service, volume-based contracts to arrangements that reward providers for the value of the care they provide.