Predictions for the US Healthcare Landscape in 2025: A Bird’s Eye View by Sanjeev Maurya

Insights from Sanjeev Maurya, Vice President of Operations, Silverskills

2024 was a fascinating and highly challenging year for the healthcare industry in the US. It witnessed increased adoption of automation by all the players in the market, including insurers, providers, and hospitals.

The industry also faced one of the worst cyber-attacks in US history – February’s attack on Change Healthcare – which crippled healthcare operations for almost half the nation and shone a light on the strategic importance of cybersecurity.

What is the healthcare industry outlook for 2025? As the industry marches forward, it will continue to face headwinds. However, there is reason for leaders to lean into cautious optimism.

The healthcare sector has spent the last few years stabilizing itself on a base of workforce shortages, a push to adopt digital transformation, and margin pressure. Hence, 2025 could prove to be a year marked by strategic growth and innovation.

2025 US Healthcare Industry Outlook

Here are some healthcare industry trends we ought to see in 2025:

• High investment in artificial intelligence (AI) and generative AI technology will continue. The focus will be on improving customer satisfaction and managing ever-rising costs.

  AI-driven tools will assist in scheduling, coding, billing, and reducing manual tasks for medical assistants and coding staff. As more healthcare companies implement AI, AI Edtech companies will also gain traction.

  Doctors, nurses, and other healthcare professionals will be expected to adapt to new technologies and remain competitive – all the while reducing burnout rates.

• It would be remiss to talk about the healthcare industry outlook without mentioning cybersecurity, which will take center stage. Indeed, in the US, a new legislation has been introduced: The Health Care Cybersecurity and Resiliency Act of 2024. Under this act, grants will be offered to healthcare organizations to help them prevent and respond to cyber-attacks.

  Furthermore, the act aims to improve coordination between the Department of Health and Human Services (HHS) and the Cybersecurity and Infrastructure Security Agency (CISA), who will be required to work together to improve cyber-threat information sharing and strengthen cyber-attack response efforts.

• Medicare Advantage plans will continue to see an upward trend with the Trump administration taking over in 2025. It will be under the leadership of Dr. Mehmet Oz, the new administrator of the Centers for Medicare and Medicaid Services (CMS), who has been a staunch supporter of Medicare Advantage expansion.
• Certain big mergers between insurers that were either held up or didn’t succeed previously will again come under the spotlight as the new administration will provide a more conducive environment.
• There may be a silver opportunity for industry concentration, where big players will acquire smaller players and expand their footprint.
• Value-based care payment models will see an increasing trend as compared to traditional fee-for-service. Providers will be aiming to provide comprehensive and holistic treatment plans for patients to meet quality program requirements.

Since it will involve a more data-driven methodology, the quality of the data will need to be maintained for appropriate reimbursement. High provider performance scores will result in providers being chased by hospitals/provider groups, resulting in more reimbursement for doctors.

In 2025, the US healthcare industry outlook is more favorable than that of 2024. Many executives anticipate rises in both revenue and profitability.

Inflation, growing demand for healthcare services, the need to balance profitability and affordability for consumers, and an uncertain fiscal outlook will stack high walls against the industry. However, the walls are not insurmountable by far: they present an opportunity to reinvent care, driving advancements for both patients and organizations.

Healthcare leaders will need to embrace a multidimensional strategy, including leveraging digital transformation, reinforcing cybersecurity and data privacy measures, and focusing on customer acquisition and retention via enhanced experiences. Through this, they should maintain a culture of innovation and resilience.

By adopting these approaches, leaders can better position their businesses for success in the uncharted waters of 2025. If you want to take a deeper dive into how you can prepare your healthcare organization for the year, contact us now and speak to one of our experts.