Healthcare stands at a pivotal crossroads. With the One Big Beautiful Bill Act (OBBBA)—signed into law on July 4, 2025—introducing sweeping cuts to Medicaid and ACA marketplaces, organizations now face a $1 trillion reduction in federal healthcare spending over the next decade, with Medicaid cuts alone approaching $900 billion (PWC). Estimates suggest that up to 10 million Americans may lose their health insurance coverage (Eleos Health).
In this volatile landscape, adaptability isn’t an option—it’s essential. From conversations with clients, what’s becoming crystal clear is this: leaders who intentionally choose what to end, how to begin anew, and how to rally their teams through turbulence will not just survive—they’ll turn disruption into transformation.
Here are five keys to jumpstart the process:
1. Choose Your Endings Before They’re Chosen for You
Change isn’t waiting around—it’s already here. When resources shift and old systems falter, those who act proactively gain the power. For example, when healthcare leaders proactively sunset outdated referral workflows, they reduce administrative drag. That space creates the opportunity to focus more on preventive care and patient engagement, which is where the biggest gains are being made.
2. Anchor Your Calm, Even When All Else Is Shifting
Stress in the system becomes stress on the system. As one director told me last month, “When I stay calm, my team trusts the path—even when we don’t see it clearly yet.” Pair simple practices—like a one-minute breath before team huddles—with regular messaging on priorities to amplify this emotional state.
3. Build Clarity from Complexity
The OBBBA’s staggered eligibility shifts, tightened criteria, and phased Medicaid reductions mean ambiguity is the only constant—but direction matters. A powerful study on organizational change in healthcare found success rates collapse when staff feel uninvolved, unprepared, or don’t see patient benefit (BMC Health Services). Counter this by mapping what is known, unknown, and next—constantly.
4. Liberate Small Acts of Courage
Whether it’s a mid-shift nurse suggesting a tech pilot or a director proposing a new cross-functional huddle, small acts of courage spark momentum. Studies show that when staff are encouraged to experiment with process changes—like testing new scheduling tools or workflow pilots—engagement rises sharply. It’s often less about the pilot itself and more about the freedom to try that shifts a culture.
5. Build Resilience Through Connection
As noted previously, studies show that when change is seen to benefit patients—and teams feel heard and prepared—resistance drops and adoption rises. Many leading systems—like Cleveland Clinic and Mayo Clinic—amplify this by building intentional connection points, such as brief cross‑department huddles or peer support check‑ins, which help diffuse pressure and maintain coordination under strain.
Why This Matters Now
- Urgency is Unavoidable: With $900B+ in projected Medicaid cuts and 10 million losing coverage, strategic response isn’t delayable.
- Most Change Projects Fail—but yours doesn’t have to: It’s widely noted that up to 70% of change initiatives falter without the right approach; only about 30% succeed (Harvard Business Review).
- Culture + Structure = Catalysts: When professionals are involved early, prepared, and see patient benefit, change sticks (BioMed Central).
A Gentle Next Step
If this feels like the right direction, there’s more we can do together. Through our Choose Your Ending keynotes and Radical Adaptability in Action coaching, we can partner to:
- Design scenario-based planning workshops to clarify “known, unknown, next.”
- Run pilot-to-scale support, enabling brave experiments that deliver early wins.
- Facilitate leadership peer cohorts to cultivate trust, resilience, and collective clarity amidst shifting regulations.
No sales pitch, just an open offer: When you’re ready, let’s explore how we can help you move from sparking ideas to shifting outcomes.
Final Thoughts
Opportunity is uncovered when you Choose Your Ending. By fostering calm, clarity, courage, and confidence, while weaving connection across your teams, you empower your people—and safeguard care for the communities that depend on it. This isn’t just leadership. It’s legacy.
###
Shawn Ellis is a nationally recognized keynote speaker, author, and consultant who helps leaders build resilience and adaptability in times of change. Through his Choose Your Ending™ and 5 C’s of Radical Adaptability frameworks, he equips organizations—including healthcare systems—with practical tools to turn disruption into growth. Contact Shawn to explore a keynote or workshop for your healthcare leadership team.