The following post is a collaborative response by our team regarding the article mentioned in the post. Contributors include: Allison McCarthy, Susan Boydell, Mitzi Kent and Amy Chandler.
A recent article from Becker’s Hospital Review, “Proposed Medicaid cuts, quantified,” estimates nearly $800 billion in federal Medicaid reductions over the next 10 years. That number is eye-catching—but the real impact could be even more profound, especially for health systems that already rely heavily on Medicaid revenue.
At Barlow/McCarthy, we’re watching closely—not just for what might be cut, but for how these shifts could reshape the work of physician recruitment and relations.
What might change?
If these cuts go through, the effects won’t just hit financials—they’ll reverberate through physician and other provider staffing strategies, market outreach, and care delivery models. Here’s where we anticipate the biggest changes:
- Recruitment in high-Medicaid markets will get harder. Physicians may hesitate to join organizations perceived as financially unstable or at risk of service reductions—especially in rural or safety-net settings.
- APPs will likely take on a larger share of care delivery. Organizations may rely more heavily on nurse practitioners, PAs, and midwives to increase access and manage costs in both primary and specialty care.
- Emergency departments will feel more pressure. Reduced funding for long-term care may push more elderly and complex patients into already-strained EDs, amplifying demand for hospitalists and ED providers.
- Outreach strategies will need to be sharper. Medicaid-heavy markets will require targeted service delivery planning, from telehealth options to hospital-at-home models, to maintain access and control volume.
- Physician recruitment and relations teams will be under more pressure to grow. But not just any growth—the right payer mix, in the right specialties, from the right physicians. Health systems will expect greater precision and stronger ROI from these teams, with a focus on provider compliment, referral alignment, and measurable contribution to strategic goals..
What should we be asking?
This isn’t just about cost reduction, it’s about rethinking how we grow and who we need to grow with. Questions worth asking now:
- What kind of volume do we truly need to grow—and where can it come from?
- Which physicians drive strategic volume, and how strong are those relationships?
- How can we position ourselves to recruit in financially vulnerable markets?
- Where do APPs and care model redesigns offer new options for coverage?
- Are we strategically prioritizing the work of our teams and equipping them with the tools and data they need to be more focused?
- How do we ensure we’re not just filling roles, but recruiting and retaining for impact?
The coming months will demand adaptability, creativity, and sharper focus from healthcare leaders. If Medicaid cuts move forward, they won’t just test budgets, they’ll test how well recruitment, relations, and market strategies can pivot to meet new realities. Now is the time to engage these questions, challenge assumptions, and prepare teams to lead through change.
Our team will continue to closely monitor this situation and do our best to help our clients find the right path forward. If you need to strategize how your program may adapt to these potential changes and/or you don’t feel ready to lead your team through these shifts, reach out to us at info@barlowmccarthy.com and we will be in touch.