Supreme Court Ruling Margin Impact Analysis

Assess the implications the final ruling on the Affordable Care Act will have on your organization

Now that the Supreme Court has ruled on the constitutionality of the Affordable Care Act (ACA), providers across the country are weighing the decision's impact on operations and future strategy.

Nearly three months to the day after the historic hearings on the ACA, the Supreme Court upheld the vast majority of the law’s provisions but declared that Congress cannot withhold federal funds for current Medicaid programs to compel states to accept funding for expanded Medicaid coverage. This effectively makes the Medicaid expansion optional at the state level.

One question for providers becomes: "If my state opts out of the Medicaid expansion, what will be the financial impact on my organization?"

The Supreme Court Ruling Margin Impact Analysis tool enables your organization to evaluate how these changes—along with the long-term economic forces of price deceleration, cost growth, and shifts in payer and case mix—are likely to affect future profitability.

Evaluating the impact of this ruling is just the first step to implementing a sustainable margin strategy, which will also require performance improvement in cost control, revenue capture, capacity management, and case mix management. If you would like to receive a customized analysis of the performance levers necessary to achieve sustainable margins or discuss the Margin Impact Analysis, please contact us.

Tool in Brief


Generate institution-specific five- and 10-year outlooks for payer mix, case mix, volume, occupancy, and operating margins.

Suggested users

Hospital executives, business planners, analysts

Type of tool

Excel-based, Calculator/Forecaster

Key Information

Estimated completion time

20 minutes

Required inputs

Basic facility data, payer/case mix, volume and occupancy projections, future payment assumptions

Tool outputs

  • Five- and 10-year payer and case mix projections
  • Estimated operating margin


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