Health system leaders are facing a federal policy environment that is moving faster than most strategic planning cycles can absorb. Site-neutral payment reform, Medicaid restructuring under HR1, and a bipartisan affordability agenda are no longer distant risks—they are actively reshaping reimbursement, service line economics, and capital planning today.
This briefing brought together policy experts from The Health Management Academy and Strategy Catalyst leadership alongside executives from Nebraska Medicine, Texas Health Resources, and CommonSpirit to decode the federal landscape and its direct implications for health system strategy. The session moves beyond headlines to examine what these shifts mean for planning cycles, payer mix, and portfolio decisions—and how peer systems are responding.
Note: Due to a technical issue, the opening segment on Affordability as a Political North Star is not included in this recording. CommonSpirit's Kevin Fleming spoke to the financial pressures bearing down on not-for-profit systems: Medicare payment rates that have grown just 5% against 14% broader inflation, over $4 billion in unpaid Medicare Advantage claims, and growing exposure from coverage lapses driven by Medicaid restructuring. The complete slide deck is available for download.