As healthcare leaders look ahead to 2025, several industry trends present new and exciting opportunities to innovate. Below, are five trends we think you should pay close attention to coupled with helpful questions to ask yourself along the way.
1. Revenue cycle management will see dramatic transformation. Over the years, revenue cycle management has seen a multitude of changes commensurate with the digitization of healthcare. More recently, ongoing healthcare staffing shortages and the desire to reduce manual effectors will enable automation to continue taking center stage. However, in 2025, organizations will also increasingly explore artificial intelligence (AI)-driven solutions and predictive analytics particularly in the realm of denial prevention to ‘level the playing field’ with payers that already use these tools. Eighty-two percent of chief financial officers say payer denials have increased significantly since pre-pandemic levels, and nearly two-thirds of healthcare organizations plan to increase spending on AI in the next three years. A major area of focus? Revenue cycle management.
With greater reliance on technology comes the need to upskill revenue cycle management staff, and in 2025, we’ll likely see individuals moving into new roles and taking on novel responsibilities related to AI validation and auditing.
One caveat? Although AI and automation will continue to reshape revenue cycle management nationwide in 2025, newer technologies certainly aren’t the panacea to addressing the medical coder shortage. An aging population (and ever-increasing claim volumes) will inspire organizations to explore outsource partnerships next year and beyond—particularly those with vendors that use a global workforce—to optimize collections and reduce the cost-to-collect.
Question: How will your organization strive to improve revenue cycle management performance?
2. Rising healthcare costs will force leaders to rethink financial growth strategies. Healthcare costs are climbing faster than national inflation levels, and by 2025, these costs will have increased by eight percent, which is the largest projected increase since 2012. As a result, healthcare organizations may look for ways to grow their profit margins, maximize revenue, and recoup rising operating expenses through health plan contracts.
Rising healthcare costs will also affect patients, many of whom may not be able to afford the healthcare services they need. Providing transparent costs and connecting patients with financial resources and counseling will be paramount. Tapping into the skill of highly trained patient call center representatives can be a powerful way to do this.
Question: How will your organization leverage its patient call center to help meet strategic objectives?
3. Digital healthcare solutions will become more integrated with population health management. Evidence-based digital health tools focused on reshaping health behaviors will continue to improve self-awareness, provide on-demand education, and promote accountability for individuals and populations. These tools will also be important in terms of paving the way for home-based healthcare. Some of these tools—particularly those that enable remote patient monitoring—may even yield new reimbursement opportunities for providers. Knowing how to leverage these opportunities to improve patient care and gain additional payment in 2025 and beyond will be paramount.
Question: How will your organization incorporate digital health into its population health management strategy?
4. Value-based care models will become more commonplace. Another trend to watch in 2025 is the evolution of hybrid payment models that combine elements of fee-for-service with value-based components. To enter hybrid models, healthcare organizations will increasingly adopt solutions that offer detailed performance analytics, predictive modeling, and automated reporting capabilities—all of which reduce the administrative burden and increase participation in value-based programs. In addition, risk-sharing arrangements will align incentives across the healthcare ecosystem, making it important for healthcare organizations to develop partnerships with social care networks and community-based organizations.
Question: What does your value-based care strategy look like, and do you have the right technology and community partnerships in place to support it?
5. Cyberattacks will remain constant. If there’s anything we learned in 2024 with February's unprecedented cyberattack, it’s that healthcare data is extremely vulnerable. As the healthcare industry becomes more digital—particularly with the rise of telemedicine and wearable technology—cybersecurity is a major concern. Healthcare organizations will increasingly turn to cloud storage and virtual private network solutions and demand that any third-party entities with which they do business with meet the highest standards for healthcare data privacy and security.
Question: Does your organization have the right people, processes, and technology in place to protect itself? Ask the same questions of your vendors.
Conclusion: Healthcare industry trends 2025
Healthcare trends for 2025 aren’t ‘new’ per say, but they are vital and should be top of mind for today’s healthcare leaders. Deciding how your organization will adapt to them is the key to success. Learn how Global Healthcare Resource can help.