New Analysis from Consumer Edge's Hydrus Medical Claims Dataset Pinpoints Facility Types and Companies Facing Financial Risk Under Upcoming Medicaid Rollback
Consumer Edge (“CE” or the “Company”), the leading provider of global consumer data-driven insights, today unveiled new data identifying segments of the U.S. healthcare system that are most at risk and financially exposed to the Medicaid reductions outlined in the One Big Beautiful Bill Act (“OBBBA”)as well as those less dependent on Medicaid and therefore less likely to be impacted.
CE's Hydrus medical claims data shows that rural health clinics, federally qualified health centers, substance abuse treatment facilities and psychiatric facilities significantly rely on Medicaid funding, making them especially vulnerable to program cuts and enrollment declines. Public companies with operational exposure in these categories include Acadia Healthcare, United Health Services, Centene and Elevance Health.
In contrast, facilities with lower Medicaid exposure-like ambulatory surgical centers, urgent care clinics, and comprehensive rehab facilities-are likely to be less affected. Companies such as Surgery Partners and Encompass Health may be better positioned due to their commercial payer concentration. Surgeries are generally underexposed to Medicaid, meaning companies with high surgery volumes, such as HCA Healthcare and Tenet, and device makers tied to elective surgeries, including Stryker and Zimmer Biomet, are also less likely to see a major impact. While rehab centers show low exposure, rehabilitative services overall remain highly Medicaid-dependent, especially in community health settings like Federally Qualified Health Centers.
To perform this analysis, CE measured “exposure” by looking at the share of Medicaid claims volume handled by each facility type and procedure category compared to the average across the U.S. healthcare system. Facilities and procedures with higher-than-average Medicaid claims volume are considered overexposed and may be more vulnerable to reimbursement shortfalls, while those that serve fewer Medicaid patients are underexposed and likely to be less affected from the effects of the bill.
“While the full impact will not be seen until 2026-when new eligibility requirements are likely to trigger a major drop in enrollment-early indicators point to specific vulnerabilities across the provider landscape,” said Julia Fitzgerald, VP, Healthcare Products, at Consumer Edge. “By identifying where Medicaid dependence is highest, our data gives stakeholders an early signal of where financial pressure is most likely to emerge and where strategic pivots may be needed. This visibility is critical as the industry prepares for the next wave of policy-driven change.”
About Consumer EdgeConsumer Edge (“CE”) is a leading data and insights-as-a-service (IaaS) company specializing in the global consumer, B2B, and healthcare economies. Founded in 2009 by CEOBill Pecoriello, CE delivers real-time, transaction-based intelligence enriched by deep industry expertise. Its solutions equip corporate and investment leaders with best-in-class tools for strategic decision-making, offering granular insights and benchmarking across products, brands, sub-industries, and industries. CE's unique capabilities turn complex data into clear, actionable insights that drive smarter, faster decisions.
Consumer Edge's healthcare datasets deliver real-time, medical and pharmacy claims data and insights from millions of patients, providing unmatched visibility into procedures, therapy adoption, patient journeys, and provider trends to power data-driven healthcare insights.
Media ContactsRaquel Cona/Michaela FawcettKCSA Strategic Communicationsrcona@kcsa.com/mfawcett@kcsa.com
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SOURCE Consumer Edge
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