With federal healthcare cuts looming, how can providers better target commercially insured patients?

Hospitals and health systems are entering a period of heightened financial uncertainty as policy shifts under the Trump administration begin to take hold. Some changes are already affecting provider finances, while others slated for late 2026 and 2027 have the possibility to further disrupt the traditional revenue streams facilities are heavily reliant on.

From billions of dollars in Medicaid spending cuts and stricter eligibility requirements to the expiration of ACA subsidies and potential changes to the 340B drug pricing program, many providers are feeling the financial squeeze. Together (and alongside other economic factors), health systems must move quickly to stabilize their margins while balancing the need to grow as a business and serve their communities in an environment with less dependable federal reimbursement.

Against this backdrop, commercially insured patients are becoming increasingly important to hospitals’ and health systems’ financial strategies. However, finding and engaging these patients is far from simple, especially as patients have more freedom in how and where they receive care. To succeed, providers need a clearer picture of why this audience is becoming strategically important—and what it takes to reach them with confidence.

What makes commercially insured patients an attractive audience

While no payor segment will be the silver bullet solution to today’s financial challenges, investing more resources into commercially insured patients is one way hospitals and health systems can weather the financial turbulence on the horizon. Here are two reasons why:

Commercial payors represent the largest share of hospital revenue

No surprise here—commercial and private insurers collectively make up the largest share of hospital net patient revenue for U.S. facilities. According to a Definitive Healthcare payor mix analysis, this segment accounted for roughly 70% of average hospital net patient revenue in 2023, compared to about 15% from both Medicare and Medicaid respectively.

This is in part because hospitals can negotiate significantly higher reimbursement rates from commercially insured patients compared to Medicare and Medicaid, which are more fixed. In fact, a 2022 study from RAND found that, across all inpatient and outpatient services, commercial and private insurers paid on average 254% of what Medicare would have paid for the same services at the same facilities.

This gap is one of the reasons why revenue from commercial sources is so financially important to providers. As reimbursement tightens under new and upcoming federal policies, and coverage uncertainty grows as potentially millions of people lose access to ACA marketplaces or Medicaid (through eligibility restrictions), commercial revenue can help offset rising operating costs and support underpaid service lines.

Strong alignment with high-margin service lines

Commercially insured patients are usually more likely to use services that support hospital and health system margins, including orthopedics, cardiovascular care, women’s health, elective surgeries, and advanced imaging.

Many of these service lines are affected by Medicare reimbursement changes, including the phase-out of the CMS IPO list, and are relied on by hospitals to offset lower-paying services. While these changes offer greater flexibility in where patients go for procedures they need, some hospitals may be vulnerable to disruptions in revenue, making commercial demand especially valuable for sustaining performance.

Reaching privately insured patients is easier said than done

While commercial and privately insured patients still represent a solid financial opportunity for hospitals and health systems amidst a changing economic landscape, finding and engaging this population is easier said than done. Today’s healthcare market is more fragmented and competitive than ever, and is increasingly consumer- and value-driven, making precise audience targeting both more important to provider success and yet more difficult.

The fragmentation of healthcare data is one major hurdle providers must overcome if they want to reach the right segment of commercially insured patients. And this problem can permeate across an entire organization. For example, payor insights might reside in a provider’s financial systems while consumer behavior data exists in marketing platforms, and referral and utilization data lives in other separate tools. Without a clear, unified picture of the market, it can be a struggle to understand where the right patients are, which services they need, and where they may be leaking to competitors.

At the same time, patient choice is expanding. Commercially insured patients are setting high standards on providers and are making choices based on convenience, cost transparency, access, experience, and more. This growing complexity means providers must rethink how they approach visibility and patient engagement. The practices that fail to meet patients where they are risk becoming invisible.

Finally, the providers leading the pack recognize that traditional demographic targeting is no longer sufficient. A patient’s age, income, and geographic location can all provide useful context, but they rarely capture the full picture. Two patients in the same ZIP code may have very different insurance coverage, network access, and care-seeking behavior.

How providers can find and reach commercially insured patients faster

As the clinical and economic landscape of healthcare changes, it’s clear that hospitals and health systems need more powerful datasets and analytical tools to find, segment, and engage their ideal patients.

Enter: Definitive Healthcare’s Digital Audiences solution.

Digital Audiences helps providers like you market to patients with confidence and in compliance, thanks in part to a massive database of more than 225 million HIPAA-compliant consumer records and 500+ health attributes. Then, armed with these insights, your marketing team can launch more targeted campaigns and generate measurable results.

For example, Digital Audiences can support campaigns targeting commercially insured patients across service lines such as cardiovascular care, orthopedics, women’s health, oncology screening, metabolic health, and outpatient procedural services—helping providers reach patients earlier in their care journey and align outreach with high-value service line growth.

Just as importantly, all engagement is built on a privacy-first, HIPAA-compliant foundation. Digital Audiences are constructed using de-identified data and designed to support compliant activation across digital channels. This allows hospitals and health systems to engage commercially insured populations responsibly, maintaining patient trust while still driving performance and measurable ROI.

Ready to take the next step? Learn more about Digital Audiences here and fill out the form to start building specialized audiences for your campaign needs. Or book a demo today to get hands-on with the data you need to get a clearer picture of your market.