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Becker’s Healthcare Podcast
Molly Gamble on Five Questions Healthcare CEOs Are Grappling With Today
00:07:49
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- [00:01]
A
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- [00:38]
B
Hello and welcome to the Becker's Healthcare Podcast. My name is Shanelle Bunger and today I'm excited to speak with Molly Gamble, Vice President of Editorial at Becker's Healthcare that joins us weekly to share insights in a healthcare trend she's keeping an eye on. Molly, thank you as always for joining me today. Why don't you take it away and tell us about some of the things you're seeing out there.
- [00:55]
C
Yes, thank you so much, Chanel. So we are in just this summer has gone by quickly and slowly at the same time, it seems. And in these last few weeks I've been reflecting on the summer's events, specifically what this has meant for health system CEOs across the country. And I keep coming up against these five questions that I hear CEOs really grappling with right now that I thought I'd touch on for listeners. You know, one is what's the real financial hit to my system from obbba? This is a question that one might assume all the endless scenario planning that dominated the first half of the year would leave executive teams with clear answers to. At the same time, this reality of $911 billion cut to federal Medicaid funding, an estimated 17 million more uninsured over the next decade. These things in the day to day can be less clear. So three truths are standing out with this big question. You know, first, no system is looking at a financial lift from this law that was signed 4th of July. Second, the severity of those headwinds from challenging to devastating. It depends a lot on state policy and payment models, market dynamics, population needs, specialty mix, payer relationships, medical school affiliations. There's a lot of local factors that will influence how hard health systems are hit from some of the funding and insurance changes under this legislation. And then third, I would say that the obbba, it's only one piece of the puzzle. You've got other cuts on the table, NIH funding cuts, tax tariffs, inflation still threatening to compound its costs. So I'm hearing from CEOs some are drafting doomsday plans, others are looking at their nuclear options as they call it. And that's strong language. Chanel from the C Suite. So at the same time others are feeling like they are effectively paralyzed and have little room to plan at all. So that's a lot of what I'm hearing from leaders on that. One question about the real financial hit. I would say the second question they're facing is how much influence do health systems have now? This is a puzzling one. Leading up to 4th of July, health system leaders across the country were really outspoken about the damage that was set to take effect if those spending reductions and coverage changes would actually go through. As CEOs travel to Washington, they traveled to their state capitals, they met with lawmakers and really they talked about the risks of hospital closures, service cuts, care deserts, and did those efforts move the needle? It's hard to see evidence that they did. And for many leaders, this moment will feel less familiar to them. You have a moment where ideologies in some ways outweighing policy and those traditional levers of lobbying, advocacy, building coalitions may no longer have the influence that they once did. So it's a question of what now health system influence looks like, how our health system is not only heard, but actually also securing the outcomes they need. The third question, I think this is going to be one that's going to play out over the next couple, three, four years. But what's an OBBBA reaction versus a change that I would need to make anyway? This legislation, I can't help but think was passed at a pretty interesting time for health systems. You have, you're seeing at the access of what could unfold with AI in terms of outsourcing, augmenting, automating, different workflows, mostly on the administrative side of things. And there could be some times where we saw this with COVID Across all industries, businesses would make what could be difficult or unpopular decisions, but they would chalk them up to the pandemic. I'm curious if that will happen given what health systems might need to do to save resources. If they need to consolidate low volume service lines, outsource different functions to AI, trim their administrative headcount, the OBBBA could make for a very large umbrella of why a lot of different activity like that takes place. But I also wonder sometimes how much of that was necessary regardless of this law, what maybe was being kicked down the road or avoided that now this legislation just makes absolutely necessary for health systems. This next one I'm going to be really interested to continue to learn more about from our leaders and CEOs. But how do they lead when the decline happens drip by drip? Ironically, with this legislation, the most significant rollback of health insurance coverage ever driven by federal policy, that's going to happen in what might feel less like a flood than a slow drip. The impact here is expected to unfold unevenly. We had one CEO describe it as a slow degradation of services that you'll see year over year. That pace, that slow pace that can complicate planning. It can complicate leadership. In some ways, leading through acute crisis is easier. The urgency is completely clear. You have all hands. Mobilizing collaboration is expected. The high stakes of those crises are understood. But a crisis that crawls can demand different muscles of leaders. You have to really sustain urgency when the pressure is uneven. You've got to rally teams without maybe a single inflection point. And you have to make some hard choices before the pain is fully felt. And then the last question. This is one that will be with us regardless of who is in the White House, regardless of administration and regardless of legislation. What do physician and labor shortages look like now? So for all the new headwinds that we've discussed and seen in 2025 so far, one challenge remains so stubbornly familiar. That's the bad math between healthcare supply and demand. This is something that Scott Becker, I know has spoken at length about. It's something we continue to write about together. But bottom line is we have 340 million Americans who rely on about 840,000 direct patient care physicians, 5.3 million nurses. And those shortages extend all through allied health providers and critical support staff, too. So the question is not whether shortages persist, but how much more destabilizing they will become. And this legislation did not address that gap, but it stands to probably have some headwinds and effects on it, which we'll continue to watch for and report on. But that's one question, Chanel, that regardless of the current events, I think so often we are talking about the symptoms of those math problems in healthcare versus the actual root cause. So I hope that there will, in some ways, as much as we can channel and rouse, continue to be some energy and focus and attention on that very, very serious need.
- [07:37]
B
Perfect. Well, Molly, I want to thank you for always keeping us updated on all these important healthcare trends and for joining me on the Beckers Healthcare podcast. Thank you so much.
- [07:46]
C
Thank you, Chanel.