Navigating the Crossroads of Policy and Politics: Key Takeaways from Premier’s Government Affairs Presentation at Breakthroughs 25

Key Takeaways:

• Healthcare providers are facing intensified scrutiny and financial pressures, with policymakers enacting sweeping reforms that demand immediate adaptation and advocacy from hospitals and health systems.
• Despite political shifts and regulatory rollbacks, value-based care, Medicare Advantage oversight, supply chain resiliency and drug pricing reform remain central pillars of federal policy, requiring providers to stay engaged and proactive in shaping their future.
• Premier continues to lead the charge in supporting providers through unprecedented change, from advancing supply chain resiliency and cybersecurity to championing maternal health.

At Premier’s Breakthroughs25 Conference, Soumi Saha, Senior Vice President of Government Affairs, explored the trajectory of healthcare policy in 2025—examining how reality has aligned with, or deviated from, expectations coming into the year. With a sharp eye on the evolving political landscape, she offered a candid and comprehensive look at the current and future state of healthcare policy, and what it means for providers, patients and the broader healthcare ecosystem.

Here are the key themes and takeaways from the presentation:

1. Hospitals and Nursing Homes Under the Microscope

When looking at our present moment, it’s important to acknowledge a sobering truth: the provider community has experienced a dramatic shift in public perception—going from “heroes” during the pandemic to being under intense scrutiny in today’s policy environment.

At last year’s Breakthroughs, Premier predicted that hospitals, nursing homes and providers at large would face heightened oversight, regardless of the 2024 election outcome. That forecast has proven accurate.

In 2025, scrutiny on providers has materialized through a series of impactful policies and proposals, including:

• Expanded transparency and reporting requirements
• Continued downward pressure on provider reimbursement rates
• Broader implementation of site-neutral payment policies
• Clawbacks of 340B drug discount funds

The message from Washington is clear: There is no mandate to “save” healthcare providers. Instead, providers must be prepared to adapt, advocate and innovate in the face of mounting regulatory and financial pressures.

Premier’s advocacy focus: Premier remains committed to supporting its members and customers through this evolving landscape—ensuring that providers have the tools, data and policy support they need to continue delivering high-quality care under increasingly complex conditions.

2. Medicaid Reforms: The Long Game Begins Now

The One Big Beautiful Bill Act (OBBBA) is poised to reshape Medicaid over the next decade, with provisions that are estimated to reduce federal Medicaid expenditures by $1 trillion. These reductions are expected to increase the number of uninsured patients, while reductions in provider taxes also limit states’ ability to raise revenues in support of healthcare programs. While many changes are phased in, Premier emphasized the need for immediate planning. Premier expects further federal action, including administrative clarifications and potential additional cuts. The post-Chevron legal environment may also limit state Medicaid waiver flexibility.

Premier’s advocacy focus: Premier will continue to work with providers to help influence implementation of OBBA provisions and mitigate cuts to Medicaid. However, healthcare providers must begin preparing now for significant budget and revenue impacts.

3. Medicare and ACA: Unanticipated Changes

Heading into the 2024 election, Premier anticipated that large-scale structural reforms to Medicare and the Affordable Care Act (ACA) were unlikely. The Trump campaign had publicly committed to leaving both programs untouched, signaling a continuation of the status quo.

But reality has unfolded differently.

Contrary to expectations, OBBBA enactment brings a series of consequential changes to both Medicare and the ACA. These include:

• A 2.5 percent payment increase for physicians under the Medicare Physician Fee Schedule in 2026
• Elimination of the enhanced federal match for states newly expanding Medicaid under the ACA
• New work requirements and cost-sharing obligations for Medicaid beneficiaries
• Provisions that could trigger significant Medicare cuts under the Statutory PAYGO Act beginning in 2026
• The absence of a renewal for enhanced ACA premium subsidies, currently set to expire at the end of 2025

Moving forward, healthcare providers must prepare for ongoing exposure to cost offsets (“pay-fors”), such as sequestration cuts and Medicare site-neutral payment policies, in any legislative healthcare package.

Premier’s advocacy focus: In response to the current threats to provider financial viability, Premier continues to advocate for multi-year reimbursement relief, broader CMS cost data to more accurately capture rising labor costs, and the preservation of key hospital support programs so that providers can continue to serve their communities.

4. Medicare Advantage: Growth with Guardrails

As Premier predicted, Medicare Advantage (MA) enrollment continues to grow, but scrutiny has intensified. Policymakers are increasingly focused on the financial dynamics of MA plans, particularly around payment denials and delays that impact both provider viability and patient care.

Premier’s advocacy focus: Premier, alongside its members, conducted a national survey and submitted formal recommendations to CMS, highlighting the urgent need for reform. These efforts helped catalyze several key developments:

• CMS finalized policies to limit retroactive denials and automate prior authorization processes.
• Insurers covering nearly 80 percent of Americans pledged to overhaul prior authorization systems.
• The issue gained national attention, including coverage on NBC’s Today Show and Soumi’s keynote at ViVE 2025.

Premier continues to advocate for stronger accountability measures to ensure MA plans support, not hinder, timely access to patient care. Legislative priorities include:

• Prompt and Fair Pay Act (H.R. 4559): Introduces prompt payment and transparency requirements
• Improving Seniors’ Timely Access to Care Act (S. 1816 / H.R. 3514): Establishes standards for streamlining prior authorization processes
• Reducing Medically Unnecessary Delays in Care Act (H.R. 2433): Requires clinical review for prior authorization by board-certified physicians

5. Regulatory Integrity: A New Era of Deregulation

Before the 2024 election, Premier anticipated that a second Trump Administration would pursue aggressive deregulation across the federal government. That prediction has not only materialized, it has accelerated.

The Administration has launched a sweeping effort to dismantle and restructure key federal health agencies—including deep workforce reductions across CMS, FDA, NIH and CDC—calling for repealing 10 regulations for every new one issued, and pursued its own brand of “radical transparency.”

This deregulatory agenda is expected to continue, with further agency restructuring and a sustained push to limit federal oversight.

Premier’s advocacy focus: Premier has provided detailed recommendations to the Administration on reducing administrative burden for healthcare providers while preserving patient safety and care quality. Premier will continue to advocate for smart, targeted reforms that empower providers and protect patients.

6. Value-Based Care: The March Continues

Premier reaffirmed a key prediction: The transition from fee-for-service to value-based care will continue and gain momentum. Regardless of who holds political power, the shift toward models that reward outcomes over volume remains a central tenet of federal healthcare policy.

Earlier this year, CMS introduced its Innovation Center Strategy to Make America Healthy Again, a new model portfolio built around four pillars: Evidence-based prevention; patient empowerment and choice; market competition and transparency; and financial alignment and provider accountability.

While the Trump Administration supports value-based care, its approach reflects a different set of priorities with stronger emphasis on:

• Rapid deployment and evolution of models
• A preference for mandatory participation
• A definition of “value” that centers more heavily on reducing taxpayer spending

This shift presents new challenges for providers, who may struggle to keep pace with multiple, fast-moving mandatory models—especially those that lack sufficient incentives or flexibility.

Premier’s advocacy focus: Premier is working to support value-based care models that are sustainable, equitable and truly focused on both cost and quality. Specifically, Premier is advocating for:

• Renewing incentives for participating providers
• Tailored models that reflect the realities of different care settings
• Continued evolution of value-based care across the full continuum—from acute to post-acute to community-based care

7. Supply Chain Resiliency: From Policy to Practice

Premier has long anticipated that supply chain resiliency would remain a bipartisan priority—with continued emphasis on domestic manufacturing and reducing reliance on foreign suppliers. That prediction has held true, and in 2025, it’s clearer than ever that supply chain challenges are not just a pandemic-era concern—they’re a long-term national security issue.

The Trump Administration has leaned heavily on tariffs and trade policy to reshape the healthcare supply chain, just as promised. However, the pace of announcements, frequent delays and shifting implementation timelines have created a sense of policy whiplash for providers and manufacturers alike.

Premier’s advocacy focus: From the outset, Premier has advocated for a more measured approach: one that channels tariff revenues into programs that directly reinforce supply chain stability and applies trade policies in a targeted, thoughtful way to avoid unintended cost increases or product shortages.

Premier is also working with bipartisan champions in Congress to advance legislation that strengthens the U.S. healthcare supply chain. Key bills include:

• Medical Supply Chain Resiliency Act (S. 998/H.R. 2213): Authorizes trade agreements with trusted trade partner countries to diversify sourcing for medical devices and pharmaceuticals
• Our Nation’s Supply chain for Healthcare has Over Reliance Elsewhere (ONSHORE) Manufacturing Act of 2025: Establishes tax incentives to boost domestic production of essential medicine and devices
• Supply Transparency and Operational Continuity for Key (STOCK) Healthcare Supplies Act of 2025: Creates real-time inventory tracking for visibility into location and quantities of critical medical supplies

8. Drug Pricing: Reform Will Continue

Before the 2024 election, Premier anticipated that drug pricing would remain a top-tier issue, regardless of who occupied the White House. Our Advocacy team predicted that a second Trump Administration would revisit the “Most Favored Nation” (MFN) pricing model and, rather than dismantle the Inflation Reduction Act (IRA), would seek to reshape it and claim ownership. That forecast has proven remarkably accurate.

President Trump has already taken decisive action on both fronts:

• Revived the MFN model, issuing an executive order to tie U.S. drug prices to the lowest prices paid by peer nations, particularly for high-cost injectable and infusion drugs
• Modified the IRA, expanding exemptions from Medicare price negotiations and directing HHS to align timelines for small molecule and biologic drugs
• Issued executive orders aimed at accelerating generic and biosimilar approvals, reforming site-of-care payment incentives, and improving drug importation pathways

Premier’s advocacy focus: Premier’s goal is to ensure that every patient has access to the right medical supplies when they need them. To this end, Premier continues to advocate for:

• A competitive, transparent healthcare market;
• Policies that deter anti-competitive behavior; and
• Support for outcomes-based contracting.

9. Cybersecurity and Technology: Accountability and Innovation

During the presentation, Premier offered a candid assessment of the current state of healthcare technology policy: the government is moving too slowly to regulate the future—because the future is already here. While federal agencies are still debating frameworks, the healthcare industry has surged ahead, adopting digital tools and platforms that are rapidly reshaping care delivery.

Premier’s advocacy focus: Soumi emphasized the urgent need to re-center the patient-provider relationship in this evolving landscape. Her call to action for Congress and the Administration included:

• De-siloed data: Making patient information portable, standardized, and interoperable to support modern, coordinated care
• Ending data blocking: Holding vendors accountable for restricting access to patients’ own health information
• Using technology to support—not replace—human care: Ensuring digital tools enhance, rather than erode, the patient-provider connection
• Cyber resilience: Federal investment in cybersecurity infrastructure for providers, harmonized reporting requirements, and shared responsibility across the healthcare ecosystem—from hospitals to device manufacturers to software vendors
• Real-time prior authorization: Eliminating delays and denials that compromise timely treatment

10. Environmental Sustainability: Shifting Federal Priorities

Last year, we predicted a decline in federal sustainability efforts under a second Trump Administration. That forecast has come to pass.

While the HHS Climate Pledge technically remains, its removal from federal websites signals clear deprioritization. Meanwhile, the OBBBA rolled back several clean energy provisions originally enacted under the IRA, reflecting a broader retreat from climate-related investment—even as environmental risks continue to impact healthcare delivery.

Premier’s advocacy focus: While federal momentum may have slowed, Premier is committed to ensuring that providers have the tools, data and policy support they need to lead on environmental sustainability and community health. This includes:

• Helping providers prepare for and respond to climate-related disruptions;
• Reducing the healthcare sector’s carbon footprint;
• Advancing rural health access; and
• Supporting providers in addressing social determinants of health.

11. Enhancing Access for All: Leading Locally Amid Changing Federal Direction

Despite the anticipated rollback of federal health equity initiatives, Premier remains committed to advancing access to high-quality care for all communities. Despite shifting priorities in Washington, Premier and our provider members remain focused on doing what’s right for their patients and communities.

Premier’s advocacy focus: Premier will continue to advocate for policies that reduce disparities and improve outcomes, including:

• Standardized collection of socio-demographic data to better understand and address disparities
• Policies that support rural providers with the funding and flexibility needed to sustain care in underserved areas
• Expanded access to alternative payment models that enable participation from safety-net and community-based providers

12. Maternal Health: A Mixed Policy Landscape

Before the 2024 election, Premier anticipated that maternal health would receive less federal attention under a second Trump Administration, with policy decisions likely to be delegated to the states. That prediction has largely held true, but the reality has been more nuanced.

The Trump Administration has taken a dual-track approach to maternal health, rolling back some federal supports while advancing others through alternative channels. This includes a renewal of Premier’s Perinatal Improvement Collaborative, focusing on:

• Data-driven quality improvement
• Reducing disparities in maternal and infant outcomes
• Supporting providers with actionable insights and benchmarks

Premier's advocacy focus: Sharing her own recent birthing experience, Soumi expressed hope, and Premier’s dedication to, ensuring that every mother and baby have access to data-driven, patient-centered healthcare.

A Call to Action

The 2025 healthcare policy landscape has been shaped by a mix of expected and unexpected developments. What remains constant is Premier’s commitment to advocating for policies that support providers, protect patients and build a more resilient, sustainable healthcare system.

Soumi closed with a powerful reminder: “Together, we are stronger.” Rather than sitting back and letting policy unfold, Soumi called on healthcare providers and suppliers to be part of the solution—to lend their expertise, data and voice to bipartisan, evidence-based advocacy efforts aimed at creating a healthier future for all.

How Premier Can Help

Along with our advocacy efforts, Premier offers integrated technology, data and advisory services that empower organizations to manage margins effectively and navigate both the challenges and opportunities of the evolving policy landscape.

• Premier’s advisory experts partner with organizations to unlock efficiencies, transform operations and drive enterprise margin improvement.
• Premier’s Population Health Management Collaborative (PHMC), advisory services, and data and technology solutions support providers at every stage of the transition to value-based care.
• With one of the largest healthcare datasets, robust benchmarking tools, and innovative technologies like Stanson Health’s cost management and AI-powered coding optimization solutions, Premier enables providers to build a more resilient healthcare system. These capabilities equip health systems to better collaborate with state Medicaid agencies and public health departments, tackling challenges like maternal health, readmissions, and care delivery modernization.
• Premier uses AI to improve supply chain operations, helping organizations work more efficiently and reduce costs. With tools for real-time insights, demand forecasting, and inventory management, Premier helps tackle supply disruptions and streamline operations.