The ride for healthcare leaders is about to get wild. Before the election, healthcare stood at a critical precipice. Now the industry is bracing for a reckoning under the second Trump administration. The potential policy shifts are becoming clearer as the inauguration nears. Although confirmations are still pending, six key individuals slated for top healthcare positions in the federal government signal upcoming changes:

  • Robert F. Kennedy Jr. — secretary of the Department of Health and Human Services (HHS). If confirmed, Kennedy will oversee the FDA, CDC, NIH, and CMS. He has unorthodox views on vaccines and public health but strongly supports personal choice in care and primary care.
  • Dr. Mehmet Oz — head of the Centers for Medicare and Medicaid (CMS) overseeing Medicare, Medicaid, and the Children’s Health Insurance Program, as well as the Affordable Care Act’s marketplace exchange. A longtime proponent of Medicare Advantage plans, Dr. Oz is being tasked with reducing waste and fraud within CMS. His financial investments, including a stake in UnitedHealth Group, have been called into question.
  • Dr. Dave Weldon — director of the Centers for Disease Control and Prevention (CDC). A former Florida congressman, he criticized vaccine policies.
  • Dr. Marty Makary — commissioner of the Food and Drug Administration (FDA). The incoming administration wants to evaluate chemicals present in the food supply, drugs, and biologics to address the “Childhood Chronic Disease Epidemic.”
  • Dr. Jay Bhattacharya — director of the National Institutes of Health (NIH). Bhattacharya could dramatically affect the future of medical science. The NIH is the world’s largest public funder of biomedical research but is also likely to be among the top targets for restructuring. The first Trump administration proposed cutting the agency’s budget.
  • Dr. Janette Nesheiwat — surgeon general. She has emphasized the benefits of getting vaccinated against infectious diseases. President-elect Trump has touted her commitment to access to affordable, quality healthcare and empowering individuals to take charge of their health.

What Will Change In 2025 And Beyond?

This group is likely to seek major shifts in health policy and practice. Agendas that previously focused on infectious disease will now focus on root causes of all chronic diseases. Potential shifts in policy will mean:

  • Changes in coverage under the ACA. Members of the incoming administration such as vice president-elect Vance have suggested creating high-risk pools and reinstating preexisting condition restrictions. If implemented, access to affordable care will decrease, exacerbating existing and new conditions, leading to higher overall spending. Additionally, excluding vaccines from essential health benefits may give rise to higher health risks, especially in lower-income segments.
  • Medicare Advantage regaining the advantage. Health insurers offering Medicare Advantage (MA) plans had a turbulent year. The annual rate-setting process under Dr. Oz could encourage MA expansion. Health insurers would stand to benefit from higher government reimbursement, and seniors would benefit from increased market competition.
  • Price transparency getting a boost. We may see consumers benefit from a harder line on delivering price transparency. Efforts started under the first Trump administration, including on surprise medical bills, advanced under the Biden administration. Price transparency and legislation are still in their infancy, but providers and insurers should work to comply now to avoid penalties and improve customer experience.
  • Less regulatory oversight to spur innovation. Fulfilling Kennedy’s commitment to overhaul the FDA risks significant deregulation of the pharmaceutical industry. This could potentially impact safety, innovation, and access to new treatments. Stakeholders must weigh the potential benefits, such as faster availability of new therapies, against the risks, such as the impact of diminished oversight on safety and already low public trust in healthcare.

How To Prepare As Healthcare Enters A New Era

The new administration promises to revolutionize the establishment. Consumers’ distrust and dissatisfaction with the status quo is likely to incite more change. But healthcare organizations (HCOs) can prepare for and adapt to potential policy shifts by:

  1. Relieving workforce pressure before it implodes. Clinician burnout persists. A rise in preventable conditions may push the system to a breaking point. Invest in cloud computing to store and access patient data more efficiently. Employ AI-powered tools to automate administrative tasks, freeing clinicians to concentrate on patient care.
  2. Creating educational content to spur customer engagement. Leverage blogs, videos, infographics, and other media to educate customers on health topics, treatments, and preventive measures. Platforms that support SEO and discovery on third-party listings become critical to customers searching for correct information. Customer experience platforms and other orchestration platforms such as DexCare enable hospitals to extend digital borders and attract and acquire more patients.
  3. Boosting longitudinal data tracking. Potential policy changes will likely emphasize the need for continuous data collection, especially for chronic conditions, to improve health outcomes and demonstrate the effectiveness of interventions. Today, 44% of consumers indicate that they started using wearable smart devices and/or medical devices in the past 12 months to support their overall health. Focus on incorporating new data sources and improving interoperability via standards such as FHIR and patient-reported outcomes.
  4. Increasing focus on the role of environmental health. HCOs’ policies and practices should consider how environmental factors impact public health. Reducing the public’s exposure to harmful chemicals and promoting healthier living and environments will strengthen the connection between HCO and customer. It will also position HCOs to meet any new mandates.
  5. Creating efficiency and speed. The administration wants to slash $2 trillion in federal spending. Targeting improper payments and fraud in Medicare and Medicaid will mean stricter documentation requirements and increased audits, adding to providers’ burdens. People close to the administration have posted on social media about increased scrutiny on the sector’s spending on DEI efforts. HCOs should prepare for sizable, swift changes and beef up their auditing capabilities.

Want to chat about this topic and more? Forrester clients can schedule a guidance session for a deeper discussion.