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In his first days back in office, President Donald Trump issued dozens of executive orders and made leadership appointments, setting a new tone for federal healthcare policy. Among the most notable for the healthcare landscape were:

• Withdrawal from the World Health Organization (WHO): On January 20, 2025, President Trump to withdraw the U.S. from the WHO, citing the organization’s handling of the COVID-19 pandemic.
  
  Public health experts raised concerns that the withdrawal could impact global health initiatives, particularly around disease surveillance, vaccination and emergency response. The U.S. has been a major contributor to the WHO’s budget, and its departure may lead to funding shortfalls for health programs worldwide.
  
  
• Cancellation of drug pricing initiatives: President Trump that capped copayments on generic medications for Medicare and Medicaid beneficiaries, many of which come from low-income or vulnerable populations.
  
  Public health experts warn the decision could create a financial burden on patients, reducing their access to treatments. Policymakers have also argued that drug pricing reforms should be established by legislation rather than executive action, so prices are more stable.
  
  
• Reversal of public health policies: , including Executive Order 13996, which established the COVID-19 Pandemic Testing Board, and Executive Order 13997, which directed federal agencies to enhance support for COVID-19 treatments and promoted research in rural hospitals.
  
  Scientific meetings and public communications from federal health agencies were immediately halted as a result. The grant funding process and the dissemination of public health information are largely paused until further notice.
  
  
• Discontinuation of diversity, equity and inclusion (DEI) programs: An , including those within healthcare agencies. For instance, the Department of Health and Human Services was ordered to dismantle its Health Equity Task Force, which was established to address disparities in healthcare access and outcomes among marginalized communities.
  
  Experts worry that removing such programs may intensify existing disparities and lead to poorer health outcomes for vulnerable populations.

Leadership uncertainty

Implementation pathways for these actions remain uncertain, in part, because major healthcare agencies are without confirmed leaders. Trump nominated:

• Robert F. Kennedy Jr. as Secretary of Health and Human Services
• Dr. Mehmet Oz to oversee the Centers for Medicare & Medicaid Services
• Dr. Jay Bhattacharya to lead the National Institutes of Health
• Dr. Martin Makary as Commissioner of the Food and Drug Administration.

All four nominees await confirmation, with varying degrees of controversy and certainty over their appointments. Kennedy Jr. is the only nominee with a scheduled confirmation hearing, set for January 29.

Broadly, Trump’s nominations indicate a shift in the government’s approach to healthcare, with a renewed emphasis on deregulation. However, the Senate’s decisions in these confirmation hearings will also influence the direction and implementation of U.S. healthcare policy.

Immediate impacts on rural and federally qualified healthcare clinics

Despite overall uncertainty, many existing programs and regulatory updates are likely to remain intact. Rural health centers (RHCs) and federally qualified healthcare clinics (FQHCs) should prepare for:

1. Care coordination services expansion

As of January 1, 2025, care coordination services for RHCs and FQHCs are expanded to include advanced primary care management services. The expansion aims to incentivize comprehensive care models and improve patient outcomes.

Care coordination services now cover:

• Chronic care and chronic pain management
• Community health integration
• General behavioral health integration
• Primary care
• Principle illness navigation and peer support
• Remote monitoring (physiologic and therapeutic)
• Transitional care management

Each service should be billed individually using the appropriate CPT/HCPCS base code, replacing HCPCS code G0511. Payment for these services aligns with national nonfacility Physician Fee Schedule rates. Individual billing begins January 1, 2025, although clinics may continue to use G0511 through July 1, 2025.

2. Permanent telehealth regulations

Temporary waivers have become permanent, benefiting both providers and patients. Key updates affect:

• Reimbursement parity: Telehealth services are now reimbursed at the same rates as in-person consultations for specified services.
  
  
• Cross-state licensure: Telehealth licensure is standardizing across states, potentially improving access to care for rural patients. Providers should review state-specific licensure requirements for compliance.
  
  
• Enhanced privacy and security: Stricter adherence to HIPAA regulations helps ensure patient data is protected on telehealth platforms and during telehealth interactions.

3. Staffing and workforce regulations

Staffing shortages and burnout remain central to healthcare reform. Key initiatives include:

• Mandatory staffing ratios: Some states have mandated nurse-to-patient ratios for long-term care facilities and hospital units, such as ICUs. Other states have mandated public disclosure of staffing ratios or required hospitals to establish staffing committees to manage coverage. While RHCs and FQHCs may not fall under hospital-focused ratio mandates, they are notable because they could create downstream effects, such as increased competition for nursing staff.
  
  
• Reduced documentation requirements: Programs like CMS’ Patients Over Paperwork and the 21^st Century Cures Act aim to streamline electronic health record processes and reduce the administrative burden on providers. RHCs and FQHCs must adopt compliant EHR systems to meet regulatory requirements.
  
  
• Training and development grants: Federal funding mechanisms have expanded in recent years to support workforce development in underserved areas and specialties. Check the National Health Service Corps, the Nurse Corps and state-specific programs for scholarships, grants and loan repayment incentives for underserved regions.

4. Prior authorization modernization

By 2027, for prior authorization, replacing inefficient, paper-based processes with APIs. 2025 should serve as a preparatory year, including testing and incremental adoption of electronic systems. The regulation also includes milestones to modernize EOB processes by 2026, making them more transparent and accessible to patients.

There are no indications these expectations will change or deadlines slip.

5. Renewed focus on cybersecurity

With the rise of telehealth and digital health records, cybersecurity will be a key focus of this and all future administrations.

New regulations are likely to emphasize data protection and HIPAA compliance to safeguard patient information. Incident response is another likely priority. Clinics need protocols to address cyber threats and maintain operational continuity during breaches.

Implications for the healthcare industry

Adapting to policy change is not easy — nor is the path clear. As the landscape evolves, providers must stay informed and invest in technology, staffing and training to ensure rural patients receive equitable access to care. RHCs and FQHCs can find opportunities to improve care within these regulatory changes.

While federal regulations set baseline standards, the details of regulations are often determined at the state level. Providers have an important opportunity to advocate locally for policies and resources for their communities.

How Wipfli can help

What’s next? Wipfli can help you navigate this new environment so you can focus on your mission: serving vulnerable populations and improving health outcomes. Our team is ready to help you adapt to new challenges without compromising patient-centered care, compliance or innovation. To hear more of our perspective, visit our healthcare page or contact us to learn more. Visit our 2025 regulatory, policy and tax changes for latest updates to administration policies impacting your industry.