Following the July 4 passage of the One Big Beautiful Bill Act, Allina Health Senior Vice President and Chief Human Resources Officer Sarah Stumme is among the health system leaders considering workforce strategies, while emphasizing continued commitment to employees.
The law includes Medicaid changes, such as tighter federal oversight of Medicaid provider taxes and new work requirements. The Congressional Budget Office estimates Medicaid spending will decrease by nearly $1 trillion over the next decade. The law also phases out enhanced federal medical assistance percentage incentives connected to provider taxes and restricts ACA premium tax credits eligibility.
These provisions will affect health systems differently based on workforce size, geography and whether their states have expanded Medicaid.
Minneapolis-based Allina Health operates 12 hospital campuses, more than 60 primary care clinics and 20 same-day and urgent care centers, with 27,865 care team members. Ms. Stumme spoke with Becker’s about her perspective related to the law and the workforce.
Editor’s note: Responses have been lightly edited for length and clarity.
Question: How is Allina Health modeling the potential workforce impact of the OBBBA’s Medicaid changes, particularly around demand shifts or changes in payer mix?
Sarah Stumme: Our approach starts with data analysis. The data will point to the areas that may need attention or adjustments due to the changes. There are many factors of a complex healthcare system, like access and affordability. Navigating these dynamics is a core part of the complexity the industry is managing as we work to empower individuals in their healthcare decisions.
Q: As financial pressures from the OBBBA increase, how are you approaching workforce planning? Are you rethinking roles, care models, or staffing ratios in any areas?
SS: As financial pressures from the OBBBA continue to shape the healthcare landscape, we are taking a proactive and strategic approach to workforce planning. Healthcare is inherently labor intensive, and we remain committed to delivering safe, high-quality and equitable care.
We are leveraging technology — including artificial intelligence and digital automation — to reduce administrative burdens and create efficiencies that allow our nurses and providers to focus more on patient care. These innovations are helping us rethink traditional roles and care models in ways that build capacity and improve outcomes.
While some roles may evolve or be redeployed over time, our goal is to support our workforce through these transitions and ensure that every change aligns with our mission and values. We recognize that the impact of these provisions will vary across health systems depending on workforce size, geography and Medicaid expansion status.
Q: What’s been your approach to communicating and sustaining workforce morale amid the uncertainty and anxiety the OBBBA has introduced, especially among front-line teams?
SS: We understand that the OBBBA has introduced uncertainty across the healthcare landscape, and we’re committed to supporting our workforce — especially our front-line teams — through clear and consistent communication. To address this, we’ve built a structured communication cascade. It starts with monthly meetings for vice presidents, providing them a regular format and time to process the content. We then engage directors, who pass it along to managers and supervisors. We also hold all-leader town halls and provide presentation packages that include financials, context and talking points.
While we know not every message reaches every employee, we’ve set clear expectations for leaders to carry the message forward. We’re committed to transparency and responsiveness and always open to feedback that helps us better support our teams, especially during times of change.
Q: Are you seeing any early signs that the OBBBA may affect recruiting or retention? And if so, how are you adjusting strategy to stay competitive and mission aligned?
SS: Voluntary turnover has returned to pre-COVID levels, which is the result of intentional work by our leaders over the past few years. Like many organizations, we continue to navigate financial pressures that could impact our ability to sustain this stability long term. The OBBBA adds complexity, but our focus remains on keeping our workforce engaged and aligned with our mission, vision and values. In a dispersed environment, that means ensuring every leader is equipped and accountable for reinforcing that alignment. We’re investing in leadership communication, clarity of purpose and consistent messaging to help our teams stay connected and committed, even amid uncertainty.
