The healthcare industry in 2025 stands at the crossroads of innovation and complexity, driven by technological advancements, shifting patient expectations, and evolving financial models. As artificial intelligence, telemedicine, and precision medicine reshape care delivery, the business side of healthcare must adapt to new challenges and opportunities. Simultaneously, rising costs, regulatory changes, and the demand for equitable access compel organizations to rethink their financial strategies.
We asked our experts what they think we will see in 2025. Here is what they had to say. And check out all our prediction posts looking to 2025
Jay Anders, MD, Chief Medical Officer, Medicomp Systems
LinkedIn: Jay Anders, MD
The pharmacy sector will face increased scrutiny in 2025 over AI-enabled prescription verification and clinical documentation systems, particularly as concerns mount about synthetic data usage in healthcare AI. Smart pharmacies will adopt point-of-care validation tools that combine AI efficiency with pharmacist oversight, ensuring accurate medication documentation while protecting patient safety.
Won Andersen, COO, Purchaser Business Group on Health
LinkedIn: Won Andersen
In 2025, we expect to see more market-based reforms in health care price transparency as part of the Consolidated Appropriations Act of 2021. These laws build upon and emphasize the preexisting fiduciary responsibilities employers have, requiring them to seek, understand and use newly disclosed health care pricing and fee information to ultimately lower their health care costs.
Lani Bertrand, RPh, Senior Director of Clinical Marketing & Thought Leadership, Omnicell
LinkedIn: Lani Bertrand
Centralized Pharmacy Services Models Optimize Costs
Hospitals continue to face financial pressures due to rising drug prices, the introduction of high-cost medications, and ongoing drug shortages. In response, health systems are going to move to centralized pharmacy models to optimize medication management—one of their most significant cost drivers. Consolidating pharmacy services can lead to enhanced operational efficiency and patient safety, improved inventory accuracy, and better resource allocations. These models provide a comprehensive view of medication inventory across multiple locations, enabling smarter purchasing strategies, bulk-ordering efficiencies, and better alignment with real-world utilization. This approach will reduce waste, mitigate the impact of drug shortages, and ensure consistent availability of critical medications.
Smart tech is sharpening safety in the OR
Automated medication dispensing is the standard of care on nursing floors, helping to ensure the “five rights” of medication administration. Automation is now extending into another critical area of patient care – the OR. OR-specific automation solutions provide real-time medication tracking and accountability, with optimized workflows designed to reduce errors and improve safety. Anesthesiology providers are embracing this important technology, which allows them to shift focus from manual dispensing tasks to direct patient care.
Lathe Bigler, General Manager, FDB Vela™
LinkedIn: Lathe Bigler
The recent increase of healthcare cyberattacks, including the devastating Change Healthcare and CrowdStrike incidents, will drive more organizations in 2025 to expand and improve their disaster prevention and response strategies. For example, many health systems, pharmacies and payers are exploring opportunities for redundancy, where a system design is intentionally duplicated in case of a failure so operations can be maintained to protect patients and the organization. This could include EHRs, ePrescribing networks, or imaging platforms that enable the seamless flow of critical information required to deliver care safely. Implementing an additional system or network that can be easily switched to in response to a catastrophic event is increasingly becoming a necessity rather than a convenience.
Emily Bonham, Senior Vice President of Product Management, AGS Health
LinkedIn: Emily Bonham
The future landscape of healthcare business and finance will be driven by rising administrative complexities, workforce challenges, and the transformative potential of AI and automation. Emily Bonham, Senior Vice President of Product Management, shares the following:
Staff burnout and financial pressures will remain significant challenges for healthcare providers in 2025. Rising denial rates and increasingly complex payer requirements, especially for prior authorizations, are intensifying administrative burdens. This growing strain further challenges both clinical and non-clinical workforces, making it even more difficult and costly to attract and retain skilled talent.
To address these challenges, healthcare leaders are expected to adopt a combination of onshore, nearshore, and offshore outsourcing models, along with advanced automation. By delegating administrative tasks, such as clinical documentation integrity, utilization management, and clinical denial appeals, to these resources, organizations can alleviate staff burnout, streamline operations, lower costs, and enhance patient care outcomes.
Looking ahead, we’ll also see more emphasis on balancing innovation with usability for clinical staff. Ambient technology at the point of care is already beginning to ease administrative burdens for clinicians. I believe we’re approaching a tipping point where physicians will see technology as an asset rather than a burden—a shift that has long been needed in electronic health record (EHR) systems. As the EHR market continues to consolidate, it’s essential to make space for disruptive technologies that save time, lower costs, and ultimately improve patient care.
Mike Cardamone, CEO, Forum Ventures
LinkedIn: Michael Cardamone
In order for early stage healthtech founders to get in front of top executives at the forefront of innovation, there are a few things to look for: prospects that have a tendency to be an early adopter, doctors at health systems that have been advisors at other successful health tech startups, health systems with venture arms or technology development teams and ideally have invested in companies as early as seed stage, or finally health systems who have a Chief Innovation Officer and that person is connected to early stage VC’s and/or startup founders on Linkedin.
Michael Combs, President & CEO, CorVel Corporation
LinkedIn: Michael Combs
Emerging technologies like generative AI must prove their value and ROI in 2025. Employers will increasingly seek out partners with measurable impact of technology investments on results and outcomes.
Jason Considine, Chief Commercial Officer, Experian Health
LinkedIn: Jason Considine
In the coming years, claim denials will become an even greater focus for revenue cycle management leaders as healthcare complexity continues to rise. Experian Health’s latest Claims Survey shows that, despite awareness of the issue, claim denials have increased 73% in 2024, up from 42% in 2022. Missing or inaccurate data is the largest factor contributing to these denials. Experian Health’s Patient Access Curator verifies patient eligibility within seconds but also automates finding and verifying a patient’s comprehensive insurance profile in just 30 seconds. We must take advantage of technology as it advances, and real-time data analysis enables providers to correct errors, ensure compliance with changing payer rules, and significantly reduce denial rates. Payers are already using AI so it’s important for providers to keep up with the technology on their end. The organizations that invest in these forward-thinking solutions will see fewer denials, improved cash flow, and a stronger overall financial performance in the coming year.
Tom Cowen, Head of Vertical Strategy – Healthcare & Life Sciences, Conga
LinkedIn: Tom Cowen
2025 will bring an increased focus on Gross to Net delivery for Life Sciences manufacturers. In the medical device space, a few key drivers are dragging margins lower, including inflation, higher interest rates, price pressure from healthcare providers, and broken supply chains. As costs have risen over the last few years, overall margins have suffered. As total margin percentages drop, deal-by-deal margins start to slip, with some entering single or negative-margin territory. We are seeing a concerted effort from some of our Medical Device customers to increase visibility and manage approvals and guidance more tightly to deliver on pricing and margin goals.
In the Pharmaceutical sector in 2025, we’ll see effects of 2024’s negotiation of ten leading drugs under the Inflation Reduction Act (IRA), as well as the exorbitant cost of bringing novel drugs to market. McKinsey & Co. recently reported that the number of U.S. novel drug approvals remains flat at an average of 43 per year, meaning the attrition-adjusted cost to develop a single novel asset is now estimated to be as high as $2.8 billion. With IRA cost reduction and excessive cost to entry, in 2025, Market Access teams will get more focus and resources to negotiate better deals that enhance the bottom line.
Chris Darland, CEO, Peerbridge Health
LinkedIn: Chris Darland
Next year, we’re going to hear a lot more about healthcare’s transition from a ‘sickcare’ model to a ‘wellcare’ model as more providers and payers embrace value-based care (VBC). Ninety percent of this country’s $4.5 trillion annual healthcare budget goes toward treating chronic diseases and mental health. Surgeries are expensive. Hospitalizations are expensive. Pharmaceuticals for managing advanced diseases are expensive. So much of that cost could be avoided by practicing proactive, preventive care and giving patients the tools to better manage their health. If we put more emphasis on keeping people healthy, we wouldn’t have to spend as much treating people who are sick. I also expect that telehealth and AI-based remote monitoring devices that collect patient data will continue to demonstrate their value in 2025 as enablers of wellcare.
Carmine DeNardo, RPh, Vice President and General Manager, Outpatient Pharmacy Services, Omnicell
LinkedIn: Carmine DeNardo
The Future of Care Beyond Hospital Walls
The ongoing development of specialized therapies coupled with the shift of care outside the hospital will further investment in entity-owned specialty pharmacies to help health systems manage the medication treatment journey for patients beyond traditional care facilities. These models streamline medication access and adherence, ensuring better chronic condition management and continuity of care, while also serving as a growth opportunity for the health system, empowering them to provide integrated, patient-centered solutions while optimizing savings.
Joe DeVivo, President and CEO, Butterfly Network
LinkedIn: Joe DeVivo
The Rise of Digital Ultrasound and Enterprise Integration
2025 will usher in a significant transformation for the healthcare industry, with the integration of digital ultrasound technology and the establishment of enterprise ultrasound programs in hospitals. As analog devices become obsolete, healthcare institutions will recognize the value of adopting digital solutions that enhance diagnostic capabilities. This shift will lead to the institutionalization of ultrasound use across various departments, allowing for seamless integration into existing systems. By creating an enterprise ultrasound program – in which an organization institutionalizes the use of ultrasound devices across multiple departments –hospitals will not only improve patient care but also streamline workflows and reduce costs. The combination of advanced digital tools and a collaborative approach will empower clinicians to utilize ultrasound more effectively – ultimately enhancing the quality of care provided to patients.
Joe Dore, President, USBenefits Insurance Services
LinkedIn: Joseph Dore
The continued escalation in healthcare premiums and medical costs is a complex topic with fingers pointing everywhere – passing the blame game like a hot potato. Various data sources point to four contributing factors – 1) hospitals (inclusive of clinics, urgent care and surgical centers), 2) physicians, 3) prescription drugs and 4) huge mark ups on medical supplies.
Employers offering healthcare benefits have been challenged over the years to effectively manage the costs not only for their budgetary purposes, while attempting to keep the costs affordable for employees. In 2014, the average annual premium for family coverage was $16,834, while ten years later, it’s $25,572. That’s nearly a 52% increase, which significantly outpaced the consumer price index during the same period. This resulted in some employers either not offering healthcare and/or shifting some of the costs to the employees, such as via high-deductible programs, which have grown in use by approximately 35% from 2014 to 2024.
To that end, I encourage you to become engaged and pressure your respective political representatives and regulatory agencies to make meaningful legislative changes, which can include but not limited to greater enforcement of the transparency act, additional consumer protection regulations and improved tax relief provisions for bad debt and write offs. Until then, the market will continue to increase its costs until everything is mortgaged.
Rom Eizenberg, CRO, Kontakt.io
LinkedIn: Rom Eizenberg
As the RTLS industry reaches a quarter-century of maturity in healthcare, it will move beyond its traditional focal points of locating assets such as medical equipment and managing staff safety. The last domain, and major growth driver of RTLS in healthcare, will be monitoring and optimizing the patient journey to improve wait times, identify and overcome bottlenecks, and reduce patient stays.
Bob Farrell, CEO, mPulse
LinkedIn: Robert Farrell
Engagability and Resource Prioritization: Robust digital engagement technologies and generate deep insights about health plan members. By analyzing this data, health plans can create models about the ‘engagability’ of different members. This analysis provides key information about who should be engaged, on what topics and how they should be engaged over different channels. By aligning this data with organizational goals, health plans will prioritize their resources across engagement programs to optimize business outcomes.
Journey Views: With detailed insights about member engagement touchpoints, health plans have access to retrospective and forward-looking journey views across digital and other touchpoints with the plan. These data will allow plans to map optimal touchpoints at the individual level to drive business outcomes and then align across departments around prioritization of touchpoints to optimize the experience and business outcomes.
Gary Hamilton, CEO, InteliChart
LinkedIn: Gary Hamilton
The financial landscape of healthcare in 2025 will emphasize operational efficiency and adaptability, driven by automation and technology. Practices will address rising patient financial responsibility by implementing AI to streamline collections and improve affordability. Workforce challenges, including burnout and turnover, will push organizations to rely on automation for routine tasks, enabling staff to focus on higher-value activities. These measures will not only stabilize financial operations but also support long-term sustainability in a competitive healthcare environment.
Laurence Harris, Senior Vice President, R1
LinkedIn: Laurence Harris
In 2025, the patient financial experience will continue to be transformed by AI-driven tools that enhance transparency and convenience. From improvements in real-time cost estimates to automated payment plan administration, these tools will help patients navigate the financial aspects of their care with greater confidence. Improved communication and streamlined processes will build trust, leading to higher satisfaction, and better financial outcomes, for both patients and providers.
Jason Herzog, CO-Founder and CEO, Holon Health
LinkedIn: Jason Herzog
The future landscape of healthcare, from a business and financial perspective, is poised for transformative growth driven by the increased adoption of communication technology-based services (CTBS) and digital health innovations. Here’s what we can expect:
- Wider adoption of digital health current procedural technology (CPT) codes and clarification of regulatory frameworks will streamline reimbursement processes for CTBS. This will enable health plans to more readily cover digital tools (like therapeutic apps), making them accessible for chronic disease management across conditions like diabetes, chronic pain, obesity, and mental health.
- Providers and digital health companies stand to benefit financially from these reimbursement advancements, driving higher adoption of technology-based solutions and expanding their market reach.
- Venture capital interest will gravitate toward solutions addressing key chronic conditions, particularly those targeting underserved populations. Innovations like apps for mental health (e.g., therapy tools and crisis management platforms) and specialized solutions for substance use disorders (SUD) will attract significant funding.
Innovative solutions exemplify the use of digital health technology to overcome barriers, such as transportation challenges faced by SUD-affected individuals. These apps will drive better patient engagement and improve health outcomes in underserved demographics, while also driving down costs, creating a win-win-win solution for insurers, patients, and taxpayers.
Jim Jacobs, CEO, MediQuant
LinkedIn: Jim Jacobs
In 2025, we anticipate a complex interplay of regulatory changes, financial constraints, and technological advancements shaping the healthcare landscape. The new administration’s leadership changes in CMS and key cabinet positions introduce a dynamic of reduced regulatory oversight, particularly on the financial side, which could have ripple effects in healthcare. However, this reduction comes against a backdrop of ongoing pushback on healthcare costs, leading hospitals to closely monitor shifting policies from Washington, D.C. These dynamics, coupled with inflationary pressures and fluctuating employment rates, may ultimately influence interest rates and affect healthcare financing and capital investments.
Regulatory updates—such as the enforcement of the 21st Century Cures Act, the HTI-1 final rule, and USCDI Version 3 standards—will demand heightened attention. Compliance pressures, particularly around information blocking and cybersecurity maturity, will push CIOs and CISOs to collaborate closely. This partnership will be essential for aligning cybersecurity strategies with broader organizational goals, as the financial and operational risks of security incidents, such as ransomware attacks, continue to escalate.
Hospitals will face increased scrutiny regarding their technology investments, with a higher bar set for vetting solutions and demonstrating measurable benefits like improved productivity, enhanced security, and streamlined data management. The days of speculative AI experimentation is waning, giving way to practical, ROI-driven applications. In the context of mergers and acquisitions, rationalizing legacy systems and mitigating risks related to outdated software will be mission-critical to maintaining compliance and operational resilience.
Budgetary pressures will intensify as regulatory demands and security risks grow. While healthcare organizations have made strides in preparing for these challenges, the scale of upcoming changes will likely necessitate increased spending. Boards and executives must recognize that investments in compliance, security, and efficiency are no longer optional. To navigate this environment effectively, hospitals must strengthen cross-departmental collaboration, ensuring that input from clinical, administrative, and IT teams aligns with strategic goals and drives effective decision-making.
Melissa James, CPC, CPMA, CRC, Senior Consultant, Health Language, Wolters Kluwer Health
LinkedIn: Melissa James, CPC, CPMA, CRC
The 2024 OIG reports revealed significant overpayments tied to unsupported diagnosis codes, underscoring the urgent need for MAOs to bolster their compliance efforts. With Risk Adjustment Data Validation (RADV) audits resuming and introducing extrapolated repayment penalties for the first time, the financial stakes are higher than ever, potentially resulting in substantial repayment demands. MAOs must prepare for heightened regulatory scrutiny by implementing robust compliance frameworks, increasing retrospective chart reviews, and enhancing coding accuracy. Organizations that effectively integrate and analyze siloed clinical data while prioritizing internal audits will be better equipped to adapt to the shifting regulatory landscape in 2025 and beyond.
Gary Johnson, Chief Growth Officer, Curae
LinkedIn: Gary Johnson
In 2025 the vision and desire to run a health system, achieving a higher level of financial performance and providing the expected consumer experience, is realized with new enabling technologies emerging.
Enabling technologies, including AI agents, will be quickly developed and served up by innovative vendors offering a broader platform of services and capabilities – more from one partner, and eliminating narrow scope vendors.
Two foundational problems will be solved. First, creating a true consumer-like experience for patients, both financial and clinical. This includes patient self-scheduling and pre-service cost estimates based on patient screening and coverage eligibility (e.g., commercial insurance, eligible government-supported coverage, or philanthropic foundations for drugs or funding). Competitive retail-style financing options will also be available for patients to enroll in before receiving services, helping them cover HDHP deductibles. Second, the foundational problem in the prior-authorization process and claims denials will be solved. The right technology is here to execute these processes successfully. By resolving both problems, the accuracy and timeliness of payments will significantly improve, bringing them closer to the time of service.
In addition to the financial and consumer experience improvements, Gartner predicts that by 2025, organizations that adopt a platform-based approach to digital transformation will experience a 30% increase in operational efficiency and a 20% reduction in IT costs.
Bill Kerr, MD, MBA, CEO, Avalon Healthcare Solutions
LinkedIn: Bill Kerr
State legislatures and private health plans will act to dynamite the prior authorization logjam in 2025. This will come through various programs, including requiring electronic PA with decision deadlines, reduced or eliminated PA, ‘gold card’ programs for verified providers, and more. Lab Insight solutions will be critical to making informed PA coverage decisions and evaluating provider performance in gold card programs. These solutions enable timely, data-driven decisions that prioritize patient outcomes and cost-effectiveness.
David Kirshner, Managing Partner, LogicSource
LinkedIn: David Kirshner
The future of healthcare demands smarter financial strategies. As the former CFO of Boston Children’s Hospital, I’ve seen how targeted cost management directly improves patient care. With rising denials, tighter budgets, and shrinking reimbursements, CFOs need to rethink traditional spending—starting with non-clinical costs. Borrowing proven efficiency methods from industries like retail and financial services can help health systems streamline operations and redirect savings into patient care. Leaders who prioritize spend management and cross-industry innovation will be better equipped to deliver on what matters most: better outcomes for patients.
The future of healthcare demands smarter financial strategies. As the former CFO of Boston Children’s Hospital, I’ve seen how targeted cost management directly improves patient care. With rising denials, tighter budgets, and shrinking reimbursements, CFOs need to rethink traditional spending—starting with non-clinical costs. Borrowing proven efficiency methods from industries like retail and financial services can help health systems streamline operations and redirect savings into patient care. Leaders who prioritize spend management and cross-industry innovation will be better equipped to deliver on what matters most: better outcomes for patients.
Brad Kittredge, CEO & Co-founder, Brightside Health
LinkedIn: Brad Kittredge
Greater collaboration between traditional providers and telemental health
In 2025, I believe we will witness even more collaboration as hospitals and health systems turn to digital health solutions for support in delivering mental health care. Health systems are unable to manage the demand for care and the diversity of needs on their own. The industry will continue to take a more integrated approach between traditional healthcare and telemental healthcare for the delivery of high-quality, timely, and affordable mental health care, achieving better patient outcomes and reducing provider burden.
Making Medicaid Mental Health a Priority in 2025
Nearly 40% of the nonelderly adult Medicaid population had a mental health or substance use disorder in 2020, highlighting the critical need to prioritize this group in mental health and SUD treatment. Regardless of reimbursement rates or potential policy shifts under the incoming administration, Medicaid beneficiaries must remain a focal point of care efforts. In 2025, digital health will play an increasingly vital role in addressing these needs, providing effective pathways for high-acuity individuals and supporting long-term recovery.
Tom Langan, Interim CEO, Veradigm
LinkedIn: Tom Langan
It is becoming more financially and administratively difficult to run a healthcare provider practice. Staff shortages and increasing regulatory complexities are contributing to an ever-growing administrative burden felt by practices across the United States. As we head into 2025, I predict that practices that embrace resource-saving solutions like AI-enabled ambient scribing, mobile patient engagement platforms, and tech-enabled revenue cycle services, will be better suited to face the business and financial challenges presented to them.
Edward Lichty, Chief Operating Officer, Machinify
LinkedIn: Edward Lichty
In 2025, health plans will zero in on implementing AI in a thoughtful, transparent way to reduce admin cost while improving performance and accuracy. One specific area where AI will be implemented is in claims adjudication, which presently relies on outdated technology and duct tape solutions. Health plans have historically turned to manual processes to patch the holes, which themselves are inconsistent and slow.
The result of these inefficiencies is a bevy of claims that are paid incorrectly, resulting in wasted time and money fixing errors. Next year, we’ll see plans increasingly turn to AI to automate parts of the claim adjudication process, allowing them to pay more claims accurately the first time, significantly reducing administrative costs for all participants in the healthcare ecosystem.
Dr. Tom Milam, Chief Medical Officer, Iris Telehealth
LinkedIn: Thomas Milam, MD, MDiv
The Multi-License Solution
2025 will mark a turning point in addressing the behavioral health access crisis through the widespread adoption of multi-license care teams. Following the Centers for Medicare and Medicaid Services’ expansion of reimbursement for licensed professional counselors (LPCs) and licensed marriage and family therapists (LMFTs), and growing acceptance of physician assistants and psychiatric nurse practitioners, behavioral health organizations will dramatically increase their reliance on non-physician providers for front-line care. This shift will be particularly impactful in rural and underserved communities. While physicians will remain crucial for complex cases, the industry will embrace a more diverse provider ecosystem to meet rapidly growing demand, supported by evolving state regulations and reimbursement models.
The Behavioral Health Investment Shift
Building on COVID-19’s impact on mental health awareness, we’ll begin to see behavioral health finally receive investment parity with other medical specialties. This will drive unprecedented advancement in data science and outcomes measures, areas where behavioral health has historically lagged behind specialties like cardiology and orthopedics. The healthcare industry will invest heavily in developing more sophisticated algorithms and treatment protocols for mental health conditions, leading to more standardized, evidence-based care approaches. This shift will particularly benefit telehealth services, which will use this data to enhance virtual care delivery and tracking of patient outcomes.
John Orosco, CEO, Red Rover Health
LinkedIn: John Orosco
In 2025, healthcare organizations will continue to navigate cost pressures, prioritizing solutions that optimize financial performance without compromising care quality. A renewed focus on operational efficiency will drive investments in automation, real-time analytics, and strategic partnerships to reduce waste, enhance supply chain visibility, and improve financial outcomes. Healthcare leaders will increasingly seek technologies that align financial incentives with care delivery, fostering sustainability and long-term growth.
Chirag Patel, PharmD, MBA, Director, Product Management, FDB
LinkedIn: Chirag Patel
Retail pharmacy transformation will accelerate in 2025 as mounting workforce, reimbursement and market pressures continue to drive community pharmacies toward greater efficiency while expanding the range of patient care services. Properly aligned technology will be essential in enabling this paradigm shift. To support busy pharmacists in traditional prescription filling and new patient care duties, relevant and actionable patient and drug data must be presented at the moment they need it to ensure patient safety and optimal care. With the most meaningful information consistently delivered to pharmacists’ fingertips, retail pharmacies can effectively evolve into the healthcare destinations they aspire to become.
Kim Perry, Chief Growth Officer, emtelligent
LinkedIn: Kim Perry
In 2025, payers will increasingly rely on medically aligned AI to unlock essential insights from vast and varied patient records across populations. This technology enables precise data extraction to streamline prior authorizations, optimize risk adjustment, and enhance underwriting accuracy, giving payers a comprehensive view of each member’s health. By identifying care gaps proactively and tailoring programs to actual member needs, medical AI will play a pivotal role in advancing member wellness and driving program performance.
Nate Perry-Thistle, Chief Product & Technology Officer, CipherHealth
LinkedIn: Nate Perry-Thistle
Health Financial Strain: “Something Has to Give”
The US has a healthcare spending problem. As a share of Gross Domestic Product, healthcare spending stands at over 17%—almost $14,000 per year for every person in the country. And still, health systems face intense financial pressures, with reimbursements under strain and rising costs across the board, particularly in staffing. The current landscape points to a need for real change, and many systems are looking to technology and standardized pathways as a way to sustain quality care amidst these financial constraints. Those who can adapt by embracing efficiency and support tools will find themselves better equipped for the road ahead. In 2025, systems that adapt by maximizing efficiency through standardized care pathways and AI-backed decision support will be best positioned to maintain high-quality care under intense financial pressures.
Bethany Robertson, Clinical Executive, Wolters Kluwer Health, Learning, Research and Practice
LinkedIn: Bethany Robertson
During the third quarter of 2024, there were 27 announced hospital mergers and acquisitions, representing $13.3 billion in transacted revenue marking the highest number in seven years. As healthcare mergers and acquisitions reshape the industry, one critical yet often overlooked factor is cultural alignment, especially within care teams. This is where nursing leaders must step in—bridging the gap between clinical excellence and strategic integration. Nurse leaders, such as Chief Nursing Officers/Chief Nurse Executives, are uniquely positioned to ensure seamless integrations across healthcare facilities, promoting patient-centered care and clinical excellence while building trust and cohesion across diverse teams. These cultural and competency alignments are vital for effective collaboration in newly merged organizations, supporting a stable, unified approach to patient care and organizational success.
BJ Schaknowski, CEO, symplr
LinkedIn: BJ Schaknowski
Healthcare has been trying to fix the same problem for years: too many systems, not enough alignment and integration. And yet, as our Compass Survey shows, the industry is still bogged down by inefficiency and miscommunication. It is unacceptable that we still hear about examples of “Dr. Death” – practitioners whose patient outcomes are consistently worse than their colleagues. This is something we can fix. Integrated platforms and better IT can track and identify unsafe practitioners, restrict their rights, and pull them off schedules. In 2025, the leaders who simplify their IT infrastructure and invest in truly integrated solutions will be the ones who win. Those who fail to change? They’ll keep drowning in silos and red tape, their staff will continue to suffer from burnout and shortages, and the result will be worse patient outcomes. The future of healthcare IT isn’t about adding more tools; it’s about cutting through the noise to work smarter, not harder.
Nico Severino, Chief Revenue Officer, ClearDATA
LinkedIn: Nico Severino
The future landscape of healthcare from a business and financial perspective is likely to be shaped by several market and political dynamics. The inflation story is still in play, further restricting access to capital markets and likely driving higher merger and acquisition (M&A) activity. Expectations of the new political administration could lead to significant shifts in prioritization of cybersecurity across industries. Bringing these together for healthcare, an industry already experiencing elevated risk from cyber threats, exasperates cybersecurity challenges.
Healthcare organizations are seeking paths to improve patient care and operational efficiency – where the cloud is the foundation for success. Unfortunately, they’re deploying considerably more resources away from innovation to secure a compliant and resilient cloud. Unlocking existing resources to drive innovation will be paramount in 2025 to rebalance technological advancements with risk management. To navigate the complexities of these challenges, healthcare security and cloud leaders will begin prioritizing partners who move beyond reactive cybersecurity posture to a holistic, end-to-end approach to risk mitigation including proactive and strategic services.
As financial pressures continue to impact the industry, healthcare’s strategy for improving patient outcomes will remain critical to improving business performance. Having the confidence, they can focus on innovation of patient outcomes as opposed to securing infrastructure, will be essential to accelerating that strategy and for demonstrating the return on investment–whether it is cybersecurity or AI.
Akshay Sharma, Chief AI Officer, Lyric
LinkedIn: Akshay Sharma
In 2025, healthcare companies will begin to embrace AI-generated software, leveraging tools to expedite software development cycles and reduce costs. Organizations with robust AI governance frameworks will surge ahead, using these tools to deliver faster, more secure innovations in patient care and administrative efficiency.
Jonathan Shoemaker, CEO, ABOUT Healthcare
LinkedIn: Jonathan Shoemaker
In 2025, healthcare organizations will address financial challenges by integrating technology to optimize patient flow and reduce inefficiencies. These intelligent and AI tools will guide patients to the right care settings at the right time, balancing demand and capacity. By improving throughput and resource utilization, these solutions will alleviate financial strain while enhancing patient access and outcomes. This strategic focus on efficiency and patient-centered care will enable providers to remain competitive in an evolving market.
Laura Speyer, Co-CEO, Catch
LinkedIn: Laura Speyer
- Another year of tremendous growth for the healthcare marketplace, thanks to enhanced subsidies making individual healthcare more affordable, as well as the free digital and broker-led resources (like Catch) available to consumers.
- Rising costs make it more important than ever before to proactively manage your finances through tools like Catch.
- Companies are increasingly comfortable depending on contractors – we see this at Catch too, where almost all of our team members work on a freelance basis.
- More people are freelancing than ever, driving more demand for individual health insurance. We’re starting to see a flywheel effect where independent work is normalized, which drives more Americans to seek out independent work.
- Companies are feeling the pinch as healthcare costs rise for employers (WSJ Article). That’s going to incentivize employers to lean even more heavily on contractors, and innovative options like ICHRAs.
- There’s an increasing focus on compliance for brokers and agents following CMS’s actions to combat unethical broker behavior. The new checkpoints CMS has put in place for certain brokers, combined with constant innovation around consumer-led digital pathways, will drive more consumers to self-service experiences like Catch.
Joe Spinelli, Chief Strategy Officer, Aranscia
LinkedIn: Joe Spinelli
As the industry makes long overdue strides towards a future of democratized, interoperable patient information, a new era of efficiency and cost accountability will posit just how much impact data alone makes in direct benefit to care. Savvy payers and providers may find that hardened ROI frameworks will be more of an accelerant than a detriment to the widespread adoption of personalized care solutions that improve care and lower costs.
Workflow optimization and machine learning-process tools may appear to be the lowest hanging fruit towards care efficiency, but a growing number of solutions including proactive risk screenings, chronic disease management, and personalized medication management are showing incredible benefit when effectively implemented into a connected population and provider universe. Additionally, these solution providers are increasingly confident in establishing program economics that are based on full or partial risk-sharing structures. Payers and legislators alike should continue to align on incentivizing programmatic adoption and engagement of these novel solutions that can provide real lasting benefit to patients, and in the process, help take a bite out of future cost escalations.
Rob Stuart, Founder and President, Claim.MD
In the evolving healthcare landscape, the burden of cost is shifting significantly. Traditionally, payers bore the financial responsibility of funding EDI clearinghouses, but now they are transferring this cost onto clearinghouses, which in turn often pass it along to providers by raising prices. Many of these increased costs are embedded in full-suite EHR/EMR systems that include an internal clearinghouse. Once a large group of providers commits to such a system, they can find themselves trapped, as transitioning to a new platform is an overwhelming and costly process. This dynamic allows some systems to continually raise prices, add fees, and impose restrictions, leaving providers with few alternatives. At Claim.MD, we prioritize flexibility and choice, allowing you to partner with us without being locked into exclusivity. It’s important to consider how clearinghouses or EHR/EMR systems structure their agreements to ensure they align with your long-term needs and goals.
Lucas Tanner, CFO, Carta Healthcare
LinkedIn: Lucas Tanner
In 2025, AI will revolutionize financial operations in healthcare, driving cost-efficiency and operational excellence. AI-powered tools will streamline billing, claims processing, and revenue cycle management, reducing errors and administrative burden. Predictive analytics will optimize financial forecasting and resource allocation, while intelligent automation will enhance compliance and fraud detection. These advancements will lead to significant cost savings, improved cash flow, and more sustainable financial practices for healthcare organizations.
Dr. Luke Twelves, General Practitioner and VP of Medical, Lindus Health
LinkedIn: Dr. John (Luke) Twelves
With clinical trials becoming more patient-centric, providers and pharmacists may need to adapt to the acceleration of decentralized trials and more virtual care environments. This could involve integrating more complex patient data into pharmacy workflows, managing remote patient monitoring devices, and ensuring the accuracy and availability of trial medications to a broader patient base.
Tim Vasil, SVP of Engineering, LeanTaaS
LinkedIn: Tim Vasil
2025 promises significant technological leaps, particularly in healthcare. Generative AI will revolutionize diagnostics, drug discovery, and treatment personalization. Edge computing will empower remote healthcare, at-home monitoring, and even surgery. Explainable AI will build trust in medical and financial decisions, and liven static dashboard with actionable insights. Extended reality (XR) will transform surgical training and rehabilitation. Data management will shift towards decentralized “data mesh” models for improved efficiency.
Persistent challenges will remain, including cybersecurity threats, talent shortages, and economic headwinds. Organizations that thrive will need to prioritize continuous learning, scalable architectures, and robust security. Healthcare systems will be pressured to better integrate telehealth, mental health services, and personalized medicine. And, crucially, human-centered design, emphasizing ethics, equity, and transparency, will be paramount. As virtual assistants and real-time data analysis advance, prioritizing human well-being remains essential.