OBBBA impacts: 3 ways healthcare providers can prepare

Key takeaways:

• The One Big Beautiful Bill Act (OBBBA) went into effect on July 4, 2025, but providers won’t see its full impact until 2027.
• Providers must prepare now for the influx of self-pay patients and increased administrative burden.
• Investing in artificial intelligence and other technologies can help providers identify patterns in patient data, predict coverage risks, and automate repetitive tasks.

The recent passage of Law on a big and beautiful bill It is expected to bring sweeping reforms to the entire US healthcare ecosystem, particularly major changes to Medicaid coverage and the Affordable Care Act (ACA). To avoid defaults and lost revenue, providers must be prepared to adapt quickly. This article takes a closer look at what providers need to understand to prepare for the impact of OBBBA and optimize workflows, reduce administrative burdens, and protect revenue.

What the One Big Beautiful Bill Means for Health Care Providers

The OBBBA has a phased implementation, so providers won’t see the full impact until 2027. But providers should prepare now for the influx of self-pay patients, who account for the highest percentage of bad debt write-offs, as well as additional administrative and documentation requirements, such as stricter eligibility checks and reporting mandates. The first step for providers is to understand the impact. Next, providers must invest in the right technology (particularly AI-powered automation and front-end data solutions) to optimize workflows, reduce administrative burdens, and ensure a more efficient response to the new Medicaid landscape.

1. Conduct a Medicaid Exposure and Gap Analysis

Currently seventy-one million people enrolled in Medicaid. Over the next decade, the Congressional Budget Office (CBO) estimates that 11.8 million people will lose health insurance coverage due to upcoming policy changes, such as more frequent eligibility checks and limits on eligibility for immigrants. With a gap analysis, providers can better understand their exposure to Medicaid and how funding cuts will impact their patient-payer mix.

Key steps in conducting a Medicaid gap and exposure analysis include:

1. Ask the right questions

Providers must first determine what types of information are needed to prepare for the impact of OBBBA. It is essential to look at: – Which patients are at risk of losing coverage? – Where are there vulnerable or missing processes? – What investments in advanced technologies can be made to streamline eligibility validation?

2. Take advantage of artificial intelligence

Current gap analysis models may not be able to provide sufficient information for OBBBA preparation. However, adopting AI-powered tools offers a better way to identify accurate patient demographic and financial data, automate eligibility checks, and improve insurance discovery at or before the patient’s record.

3. Evaluate the domino effect in the financing of 340 billion

Providers must also understand how a reduction in Medicaid enrollment will impact 340B funding. This federal program allows certain health care organizations to purchase outpatient medications at a reduced cost, and funding is directly tied to medical enrollment levels. When Medicaid enrollment declines, it could affect the drug purchasing ability and financial health of hospitals.

2. Prepare for an increase in self-pay patients and uncompensated care

Policy changes under OBBBA are expected to bring an influx of self-pay patients, increasing payment delays, cancellations and uncompensated care. Providers should take proactive steps to strengthen collections efforts to mitigate potential reimbursement delays.

Investing in AI-powered analytics helps providers gain valuable insights needed to improve collections performance. Tools like Collection Optimization Manager from Experian Health offer powerful segmentation and automation based on patient-centric, data-driven insights.

When providers understand a patient’s ability and willingness to pay, billing teams can prioritize accounts for patients most likely to pay. Tools that reveal charity eligibility and payment options also generate more self-pay revenue. Refined patient education strategies will be important as patients struggle to understand their new financial responsibilities and coverage changes.

The financial impact of losing coverage

As OBBBA’s new policy changes are implemented, it is imperative to be prepared to deal with financial stress. Self-pay patients are often unable or unwilling to pay their balances in full. Nearly one in five adults Those with medical debt say they will never be able to pay it off, according to KFF data.

By 2034, uncompensated care costs are projected to increase by more than $84 billionaccording to another analysis. Additional data also suggests that OBBBA’s policy changes will impact healthcare organizations’ operating margins, and soon. By 2028, margins could drop up to 17% for systems with average net operating revenues between $1 billion and $2 billion.

3. Address administrative burdens with AI

The administrative burden of OBBBA policy changes could be as detrimental to providers as the financial impact, especially when it comes to new compliance requirements. To prepare, revenue cycle leaders must immediately find ways to prioritize and optimize operational efficiency.

Additional employment verification requirements are expected to add to the heavy paperwork burden providers already handle for Medicaid. As new eligibility reviews, employment verification rules, and immigration status checks come into effect with OBBBA, streamlining fragmented and error-prone eligibility and discovery processes will be critical.

AI-enhanced solutions, like those from Experian Health Patient Access Curator™ (PAC)Reduce billing errors and denials by flagging incomplete or inconsistent data before claims are submitted. automatically integrating data into EHR and billing systems. Streamlining front-end processes for patient registration and data collection reduces the administrative burden on already overburdened staff while maximizing reimbursements.

As the healthcare industry prepares for the implementation of OBBBA, it is clear that preparation is not one-size-fits-all.

Experian Health surveyed 200 healthcare decision makers to better understand their preparedness levels, where they will be impacted, and what they are focusing on, following the implementation of OBBBA.

The Bottom Line: Financial Resilience Depends on Preparation

OBBBA will bring significant changes to the healthcare industry, many of which could severely impact the cash flow of providers who are not adequately prepared. According to a new Experian Health SurveyOnly 14% of providers feel they are currently fully prepared for the OBBBA changes, and around 40% report the need for major updates or revisions.

However, providers that take early action and invest in scalable technology can minimize their revenue risks and compliance errors.

Jason Considine, president of Experian Health, is optimistic about the importance of preparation and the long-term impact. He says:

“The path forward is complex and will require some restructuring. If vendors focus on breaking down silos and investing in predictive AI tools, comprehensive data and adaptive workflows, there is an opportunity for radical transformation by surviving the storm.”

Jason Considine, president of Experian Health

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