What we're hearing about policy

What leaders told us

Known changes are creating urgency

Leaders consistently described the One Big Beautiful Bill Act as an accelerant rather than a strategic reset. Many said the law has forced them to prioritize initiatives that were already on their to-do lists, including cost containment, operational efficiency, and growth initiatives.

Unknown changes are creating anxiety

Leaders drew a clear distinction between policy changes they believe they can prepare for and policy changes whose future remains uncertain. Potential changes to 340B and site-neutral payment policies were among the issues most frequently cited as difficult to navigate.

State policy matters as much as federal policy

Leaders highlighted significant variation in health policy across states. While some organizations are creating buffers that may soften the impact of federal policy changes, others are taking actions that could intensify financial pressure.

Organizations are preparing for multiple futures

Organizations are actively planning for known financial headwinds while also recognizing that future policy developments could reshape their strategic assumptions.

How organizations are approaching commercial growth

What we're hearing

Commercial growth is a primary strategic objective

Some organizations continue to view commercial growth as a critical lever for financial sustainability. These organizations are targeting commercially insured patients through commercial-focused ambulatory investments, employer partnerships, and targeted market expansion strategies.

Commercial growth is part of a broader access strategy

Many organizations are investing in digital front doors, access improvements, patient experience initiatives, and consumer-facing capabilities designed to attract and retain patients regardless of payer type.

Commercial growth is purposefully de-prioritized

Some organizations view aggressive commercial growth as unrealistic, financially risky, or inconsistent with broader organizational goals. These leaders are instead focused on maximizing performance within their existing patient populations and payer mix.

What we're hearing about ambulatory strategy

What leaders told us

Organizations agree ambulatory capabilities will be critical

Few leaders questioned the long-term importance of ambulatory care. Instead, debate centered on how quickly organizations can invest and expand given current financial constraints.

Capital constraints are shaping strategy

Many organizations are balancing ambulatory ambitions against aging inpatient infrastructure, limited capital availability, and uncertainty about future cash flow.

Maturing ambulatory networks are shifting from expansion to optimization

Organizations that have already invested heavily in ambulatory infrastructure are increasingly focused on improving performance, connectivity, and utilization across existing sites rather than continually expanding their footprint.

The focus is shifting from footprint expansion to network integration

Leaders increasingly emphasized the importance of connecting facilities, services, clinicians, and patient navigation processes across the care continuum. Many viewed these capabilities as equally important as adding new physical locations.

What we're hearing about AI

What leaders told us

Ambient listening is becoming table stakes

Many leaders described ambient listening as one of the first AI use cases to achieve widespread adoption. Several indicated they are now focused less on documentation and more on what additional capabilities can be built on top of those workflows.

AI use cases are rapidly expanding

Beyond ambient documentation, leaders highlighted applications in scheduling, patient access, patient communications, workforce productivity, clinical decision support, and prior authorization support.

An AI arms race is already underway

Payers and providers are investing in competing automation capabilities, particularly around revenue cycle, payment integrity, and prior authorization functions.