Financial uncertainty isn’t new for healthcare leaders, but it’s reaching a breaking point. Between inflation, labor shortages, and looming policy changes, health systems are forced to do more with fewer resources.

According to a recent report from the American Hospital Association, hospitals absorbed $130 billion in underpayments from Medicare and Medicaid in 2023—an average increase of 14% per year since 2019. And that’s before the latest round of federal changes takes effect.

In this article, we’ll look at how those changes are creating even more urgency around cost control and how a patient-facing operating system (OS) can help you stay ahead.

Understand what the “Big Beautiful Bill” means for your revenue

A sweeping new federal bill is expected to bring major shifts in how hospitals are reimbursed, particularly around Medicaid and ACA funding. The bottom line? Less coverage for patients and less funding for providers. 

Here’s what healthcare leaders are up against:

• More uninsured patients = more unpaid care. With big cuts to Medicaid and ACA funding, nearly 12 million more people could lose coverage, leaving hospitals to pick up the tab.
• Rural hospitals are especially at risk. Cuts to Medicaid provider taxes could push over 300 rural hospitals toward service reductions or shutdown, especially those already operating on thin margins.
• Loss of supplemental Medicaid payments reduces operating revenue. The bill limits how states boost Medicaid reimbursements, stripping away funds hospitals count on to improve care or stay afloat.
• Fewer people on ACA plans = less revenue. Tighter enrollment rules and the loss of pandemic-era subsidies could mean fewer insured patients and less money coming in for providers.
• Higher copays, fewer visits. New copays of up to $35 for Medicaid patients may cause many to skip appointments, reducing visit volume and delaying conditions until they’re more costly to treat.

So, how can health systems weather these changes without overburdening staff or compromising care? A smarter, more consistent approach to operations can help.

Mitigate costs with smarter, scalable operations 

Too often, workflow inconsistencies waste time and increase the workload, especially for clinical team members. This leads to missed opportunities for quality care, with downstream impacts on clinical outcomes, patient loyalty, and HCHAPS survey scores. 

Even small improvements in admin processes, like standardizing follow-up or streamlining documentation, can free up hours so care teams can provide the high-quality, compassionate care they were trained for. 

A patient-facing OS works with the tech stacks and systems you already use to support Rounding, Outreach, and Self-Service consistently across the organization. The result? A more connected experience for patients, smoother processes for staff, and a stronger foundation for operational excellence and a stronger bottom line. 

Improve outcomes to reduce costs and risk

Improving outcomes isn’t just good care. It’s a smart way to protect your margins.

For example, effective infection prevention means shorter stays, more open beds and fewer complications. And reducing readmissions helps avoid penalties and keeps the ED available for patients who really need it. 

With the right systems and workflows in place, organizations have seen double-digit drops in hospital-acquired infections and big gains in patient experience scores. Care teams can respond to issues faster, follow up more effectively and catch problems before they escalate.

That’s exactly what one health system achieved.

ChristianaCare used CipherHealth to drive system-wide quality improvements. They saw a 41% drop in hospital-acquired infections, a 12% reduction in pressure injuries, and a 20% decrease in falls. The results earned them more than 80 Zero Harm awards and recognition among Healthgrades’ America’s 50 Best Hospitals.

Find revenue opportunities hiding in plain sight

Beyond cutting costs, health systems can bring in more revenue by taking advantage of existing programs. 

Options like the 340B drug pricing program, Transitional Care Management (TCM) and new value-based models such as TEAM reward organizations for delivering better care. But to qualify, you have to meet specific requirements, such as  timely follow-up, proper documentation and consistent communication with patients. 

But many systems still fall short.

A patient-facing OS helps close that gap by automating service recovery and streamlining workflows so nothing falls through the cracks. It provides teams a reliable way to meet the required program criteria without adding extra work. This means more opportunities to get paid for the care health systems are already delivering.

Put proven digital tools to work for your staff and bottom line

With fewer insured patients, tighter reimbursement rules, and higher operating costs, the margin for waste is gone. A patient-facing OS offers a connected scalable platform way to bring consistency, automation and real-time visibility to critical interactions with every patient. 

As important, it simplifies daily workflows and supports staff at every step, allowing organizations to operate more efficiently, meet revenue-generating program requirements, and deliver high-quality care with no extra burden required.

Curious what this could look like in your system? Let’s connect.