The implementation of the “One Big Beautiful Bill Act” (OBBBA) and several policy milestones rolling out through 2028 will redefine how Americans access and pay for their care. For health system strategists and IT leaders, OBBBA is an opportunity to reimagine the entire operating model.
Between tighter margins and the rising demand for a more integrated patient experience, new regulations are a litmus test for transformation. Simply trimming costs or leaning on old ways of working will no longer carry organizations forward. The leaders poised to make an impact will recognize that technology must move from the background to become a catalyst for equity, resilience, and meaningful patient connection.
Below are guiding imperatives and ways visionary organizations can respond.
Medicaid Redetermination: Automation for Coverage Continuity
New rules require Medicaid eligibility reviews every six months, putting coverage continuity for millions at risk. Healthcare providers can serve as critical intermediaries to close these gaps. By proactively identifying and educating beneficiaries, assisting with documentation, and updating patient records, care teams can help prevent eligible patients from losing coverage. This, in turn, prevents gaps in care for patients and unpaid claims for the providers. Automation and AI-powered tools can help manage the surge without expanding headcount.
Redefining the Digital Front Door: From Scheduling to Safety Net
As coverage loss threatens access, digital entry points can transform from a scheduling application to a vital resource for managing coverage transitions and educating patients on their care options. When designed with purpose and the patients’ goals in mind, the digital front door becomes a safety net: reducing friction, fostering engagement, and protecting continuity of care.
Price Transparency and the Self-Pay Shift
OBBBA is poised to bring even more people into the self-pay and high-deductible health plan (HDHP) category. This shift will dramatically increase patient demand for easily accessible and user-friendly healthcare cost transparency. We saw widespread legal challenges and noncompliance after the 2021 requirements from CMS for price transparency. However, things might be different moving forward, with costs becoming a far greater decision driver in patient choice for hospitals and healthcare systems.
Rural Health & Telehealth: Bridging the Gaps
The intersection of the $50 billion Rural Health Transformation Program (RHTP) and the permanent regulatory flexibility for pre-deductible telehealth visits for HDHPs presents a unique opportunity for providers. By making system network updates, implementing Remote Patient Monitoring (RPM) solutions, and defraying patient costs for internet-connected devices, health systems can utilize RHTP funds to bring chronic disease management closer to home. This helps reduce costs and enable better outcomes while addressing multiple social determinants of health.
Patient Experience, Data Quality, and AI Agents
The competition will intensify for attracting those patients who retain their coverage, and patient experience will become the key battleground. AI assistants that can triage questions, handle scheduling, and support simple clinical inquiries and tasks will reduce wait times and allow frontline teams to focus on meaningful interactions. Well-curated knowledge bases, a keen understanding of the patient jobs-to-be-done, clean data, and seamless integration across tools such as Physician Data Management (PDM) and Customer Relationship Management (CRM) will underpin AI solutions for patient acquisition and care delivery.
Value-Based Care and Integrated Services
Providers are doubling down on value-based care (VBC) to maximize reimbursement as uncompensated care grows and physician shortages continue. Newer AI agent-driven technologies can flag risks, tailor interventions, and coordinate wraparound services for at-risk patients better than ever before. Clinician decision support will continue to mature, flagging noncompliance or other risk factors that drive expensive downstream care. The integration of clinician-facing tools with patient-facing automation is where true differentiation will lie.
Content as a Catalyst for Health
Driving changes in health behavior is most effective outside the clinic walls. Precision content delivered at the right time, through the right channel, can encourage healthier choices, support self-triage, and promote adherence. Building a resilient content supply chain depends on strong data and generative technology that personalizes outreach without overloading clinical and IT teams. A strong content strategy leads to higher patient empowerment and better outcomes, delivering on your organization’s mission even for those patients who are without coverage.
The next era of healthcare will challenge leaders to invest boldly in advanced technology, talent, and operational change. True progress lies beyond system implementation. It demands aligning incentives, workflows, and culture to drive wide adoption.
OBBBA isn’t just another hurdle. It’s an opportunity to rethink, reimagine, and rebuild patient care. With equity and trust at the center. The promise for every patient, every team, and every community? A system that’s not just compliant, but truly cares.
About Priyama Barua
Priyama Barua is the VP, Group Experience Lead at MERGE, where she specializes in designing human-centric digital strategies that bridge the gap between complex health technology, marketing and patient experience. With deep expertise in user experience and digital transformation, her work focuses on humanizing the data-driven future of medicine to empower both providers and the patients they serve.
About Michael Wood
Michael Wood is the VP of AI Engineering at MERGE, bringing over 15 years of experience in navigating the complex landscape of healthcare data and marketing technology. He builds intelligent systems that translate regulatory and industry-specific requirements into actionable digital strategies, helping brands turn technical challenges into drivers of growth.
About Keir Bradshaw
Keir Bradshaw is the EVP of Solutions at MERGE and a veteran technologist with over 20 years of experience in the healthcare sector. He architects full-stack digital solutions for highly regulated industries and leads the implementation of strategic marketing technologies that drive consumer engagement and business transformation.
