Outmaneuvered and Outmessaged: Hospitals Need a Smarter Strategy Post Big Beautiful Bill
The passage of the Big Beautiful Bill (BBB) has sent shockwaves through the healthcare ecosystem. While the legislation was positioned as a cost-saving reform, experts across the provider landscape—especially those representing hospitals and health systems—warned lawmakers that the bill would threaten access to care, destabilize already under-resourced institutions (particularly in rural America), and compromise patient outcomes. Yet, despite these warnings, legislators passed it anyway.
The question now isn’t just why they did, but what hospitals must do differently to make their case in a way that actually influences future policy and critical business relationships.
Why Lawmakers Ignored the Warnings
From a political standpoint, the BBB was a win. It promised lower premiums, more “transparency,” and a crackdown on what was framed as hospital profiteering. Legislators seized the opportunity to champion a cause that polls well with voters: bringing down healthcare costs. In the age of social media soundbites, the narrative was simple: insurance companies were offering savings, hospitals were expensive, and the BBB would fix it.
Hospitals tried to counter this with data, white papers, and dire warnings—but these fell flat in a legislative environment that rewards clarity and conviction over complexity. The lobbying efforts from health systems were drowned out by simpler, emotionally resonant messaging from insurers and cost-cutting advocates. Political survival, not policy nuance, won the day.
Hospitals’ Value Messaging Is Not Landing
At the core of the problem is this: hospitals have not been telling their value story in a way that resonates with the public, policymakers, or increasingly, even with payors. The current messaging focuses on scale, patient volumes, clinical advancements, and financial pressures. But these messages fell flat with consumers, failing to connect emotionally and counteract the narrative that hospitals are bloated, bureaucratic, and overpriced.
Meanwhile, insurers and consumer advocacy groups have framed themselves as champions of affordability and access, even when their practices (like narrow networks, denials, and prior authorizations) suggest otherwise. Hospitals have yet to counter this story effectively, and the BBB’s passage makes it clear that their current communications strategy is lacking.
A Critical Moment: Messaging Before Contract Negotiations
What’s more, as a direct result of the BBB, contract negotiations between hospitals and payors are about to become even more high-stakes—and more challenging. With new regulatory pressures, tighter margins, and increased scrutiny over rate increases, hospitals will have fewer levers to pull and more pressure to justify every dollar.
That means health systems must no longer treat value messaging as something that’s reactive or episodic – or worse, optional. Payors spend countless resources building and maintaining relationships with hospitals’ shared stakeholders, including community leaders, employers, brokers, and policymakers. They are consistently in front of these groups, sharing all the ways they are working to cut costs and prioritize wellness for their members. And while many hospitals are great at telling individual patient success stories or sharing new facility news, they shy away from making clear the substantial impact they have in the communities they serve, whether as a reflection of their servant-heart mindset or to avoid scrutiny of their not-for-profit status. But hospitals’ failure to create a compelling narrative that connects their financial realities and what it truly takes to deliver high-quality, compassionate care has led to a lack of support and understanding among stakeholders who have the power to shape their business. Getting ahead of the value story is critical so that when negotiations arrive, they’re stepping in with public support and a clear, compelling story already told.
A Communications Strategy That Works
The passage of the BBB is a wake-up call: data alone isn’t persuasive, and dire warnings don’t move policy. What does? Empathy. Simplicity. Relevance. Health systems need to invest in high-quality storytelling, grassroots advocacy, and coalition-building with patients, employers, and civic leaders who understand the real value of having strong local hospitals.
If hospitals want to survive both legislative overreach and difficult payor negotiations, they need to own the narrative—early, often, and convincingly. Because if they don’t, someone else will.
