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This is the strategist in brief. For July 10th, 2025, president Trump signed the Republicans budget reconciliation bill into law. Following the legislation's passage in the house and Senate, major healthcare provisions include more than$1 trillion in cuts to Medicaid stemming from enrolling work requirements, provider tax limits and limits on state directed payments, reduce subsidies and enrollment periods for a CA marketplace Plans. A$50 billion rural health fund to offset cuts to rural providers and a temporary 2.5% increase in the physician fee schedule. The Medicaid spending reductions will have a disproportionate impact on rural and safety net providers. Health systems that manage to weather the cuts will face community pressure to pick up the slack left behind by closures, but they'll also be grappling with their own financial challenges. Pressure on margins could intensify competition for commercial volumes. Raising important questions about access and nonprofit systems mission. Several other provisions present in previous versions of the bill were removed during the legislative process, including a moratorium on state AI regulation, restrictions on gender affirming care, and Medicaid and PBM transparency requirements in Medicare Part D. Moving on to our second market scan. Surgery partners announced that its board has declined an offer by Bain Capital to fully acquire and take the company private, citing the company's strong financials and growth potential. The rejection might come down to price and timing. The A SC chain's leadership anticipates favorable market dynamics and policy headwinds that will continue to shift more care into outpatient settings. Staying public may signal a bias towards maintaining the status quo with respect to physician relationships. Which are key to scaling a successful a SC platform. In other news, Ohio's attorney General gave conditional approval to General Catalyst's acquisition of Summa Health, but also set new conditions on the deal related to charitable obligations and public health investment. Ultimately raising the purchase price by$30 million. The acquisition will give General Catalyst, a vertically integrated test bed with claims data, premium flow, and a value-based care footprint. If they succeed at transforming the financially troubled system into a strategic asset, they could set a blueprint for other acquisitions by VC and PE actors throughout the industry. In a final piece of news, virtual musculoskeletal care disruptor, hinge Health is launching a new referral network for in-person care in the second half of 2025. As disruptors like Hinge lean into a gatekeeping role for in-person services. Health systems could face referral leakage in high value areas like imaging, physical therapy, and orthopedic surgery. Digital first platforms offer a convenient and high quality user experience that health systems will need to match if they want to retain patients, regardless of clinical quality or brand recognition. That concludes this week's edition. Be sure to check out the full version on the web@hmacademy.com. Thanks for listening.