Article

OBBB and beyond: Drive strategy with localized insights

VizientArticle
By Brian Esser and Ryota Terada
3 min readOct 3, 2025
Strategy partnerships and innovationFinancial sustainability
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As the dust settles following passage of the One Big Beautiful Bill Act (OBBB), the contours of a shifting healthcare landscape are taking shape. True, the industry has faced headwinds before but, as outlined in a recent article published by Vizient, never quite like this. Health system leaders need to anticipate impacts beyond what is immediately apparent and navigate an environment with a multitude of possible future states. To succeed, organizations will need to balance the needs of emerging challenges while continuing to identify and prioritize high-confidence, bold strategic bets to accelerate transformational change.

Strategy’s role: Anticipate, localize, prioritize, communicate

Complex. Overwhelming. Wait and see. We hear these phrases during conversations with client organizations on the topic of the current policy and payment landscape. Most leadership teams, having navigated pandemic-era disruptions, updated their tool kit to include enhanced signal monitoring, agile decision-making and stricter resource management. Though helpful in the past, these efforts won’t be sufficient moving forward.

Beyond the collective industry experience of first-order impacts — utilization disruption and financial pressure — seen in the early years of the COVID-19 pandemic, organizations expect the OBBB and future regulatory efforts to produce second- and third-order impacts that are not yet clearly identified or quantified. In response, an internal, multidisciplinary flywheel that combines signal gathering and scenario planning efforts with real-time business and clinical monitoring is needed to elevate each organization’s ability to pivot immediately. This full-field approach requires strategists, operators, clinicians and finance leaders to work together and leverage integrated data to chart a path forward.

Figure 1. Data-driven approach allows for enhanced strategic planning
Data-driven approach allows for enhanced strategic planning graphic
Note: CDB = Vizient Clinical Data Base; CPSC = Clinical Practice Solutions Center®; IoC = Impact of Change®; M&A = mergers and acquisitions; CARE = Clinical Alignment and Resource Effectiveness. Sources: Vizient and Kaufman Hall Report: The more things change: navigating the next healthcare crisis under the One Big Beautiful Bill. July 18, 2025; CMS. Calendar Year 2026 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center Proposed Rule (CMS-1834-P) [fact sheet]. July 15, 2025; Health Resources and Services Administration. Fed Regist. 2025;90(146):36163–36165; Vizient Strategy Analytics, 2025.
Key executive takeaways

Vizient recommends leaders take the following steps to effectively anticipate and manage disruption.

  • Act now. Don’t wait for perfect clarity. Develop localized, actionable tactics that can be applied with confidence across a variety of scenarios.
  • Broaden focus. Evaluate clinical, operational and workforce implications — not just financial — across your System of CARE.
  • Prioritize boldly. Meeting the challenges posed in the current landscape requires accelerated transformation and maximized systemness. Make strategic choices that reflect your mission and are grounded in the communities you serve.
  • Communicate clearly. Ensure strategic intent is consistently shared across all levels.
Quick take

Imperatives key to flourishing in the face of OBBB challenges:

  • Margin transformation
  • Care delivery realignment
  • Structural resilience
  • Technological enablement
For questions related to the impacts of the One Big Beautiful Bill, please reach out to your Enterprise Partnership Principal or contact us here.
 

Authors

Brian Esser

Brian Esser

Brian Esser is a national thought leader focused on emerging topics impacting enterprise growth, scale and sustainability. He often speaks at industry conferences while engaging directly with management teams and boards on the evolving healthcare landscape and strategy formulation. Leveraging 15 years of experience, Esser’s areas of expertise include healthcare strategy, physician alignment, value-based care, payment models, strategic partnerships, market...

Ryota Terada

Ryota Terada

Ryota Terada supports Vizient’s financial strategy thought leadership related to federal and state payment and policy dynamics, revenue growth, physician alignment and value-based care. In his current role, he supports health system executives and suppliers as they navigate an uncertain and rapidly evolving landscape through future-focused research and data insights shared through publications, webinars and facilitated discussions. He earned his...