Note: This webinar was recorded in early February 2025. Especially in the political field, it can affect the perspectives shared during presentations.
A major change was expected in healthcare in 2025, and elections have since occurred.
The new presidential administration and Congress are expected to disrupt the healthcare industry to promote efficiency and care for the whole person. The government has already made significant changes to public health policies, health regulations and healthcare provider rebates.
In a recent webinar, Guidehouse partner David Brick sat down with David Johnson, leader of Center for Health Insights and CEO of 4Sight Health, and Paul Kusserow, former CEO of Amedisys, to discuss what healthcare leaders can look forward to in the next year. The panelists discussed the power of the market that will make 2025 a pivotal year for the healthcare industry, and shared why they believe healthcare will change over the next 10 years than the past 100 years.
Check out the 2025 Healthcare Outlook Webinar below and see the summary below. Learn how to prepare your organization for these changes.
Five important points
1. To reduce costs, the healthcare industry must deal with the administrative burden.
In 2025, the Healthcare System continues to tackle high management costs, accounting for one-third of total medical expenses. This burden is primarily due to the fragmented nature of the system and the complex interaction between payer and provider.
“We have a very disjointed system that requires different handoffs from a clinical perspective and different handoffs from an economic perspective,” says Kusserow. “It just created enormous costs for the system, and it has undergone enormous fragmentation.
Technology can streamline the management process, but it cannot fix a broken system on its own. In 2025, a fundamental change in payment models and care delivery is needed to reduce administrative costs.
2. Changes to the redemption model can have a significant impact on efficiency.
“We are not going to fundamentally change the way we provide care until we change the way we pay,” Johnson said. The evolution into value-based care supported by technology is expected to create a more rational relationship between management costs and care delivery in 2025.
The move to full risk contracts and surrender is gaining momentum as these models reward reduced management costs and improved care delivery. However, current service pricing models contribute to inefficiency and high costs. Addressing these challenges requires a comprehensive approach that includes payment reform, enhanced care coordination, and education that helps patients make the right choices both in navigating care and maintaining health.
“As payment models evolve and technology supports it, there can be a more reasonable relationship between management costs. “The administration believes there is a tremendous amount of waste there, and they're targeting so many.”
3. Consumers force unprecedented changes in healthcare.
Healthcare consumerism is stronger than ever, as digital health platforms provide consumers with more tools to manage their care and the Trump administration defends more consumer choices in health care decisions.
Value-based reform can be advanced by providing tools that help educate consumers and navigate health systems in ways that are useful for health, Kusserow said.
“We need to teach people how to consume health,” Kusserow said. “Americans are the best consumers in the world, so we need to be able to play consumer strength here really hard, but in healthcare they are the worst.
4. 2025 will be the year of care for all.
The Trump administration has repeatedly expressed its desire to focus on care for all, a position that is expected to take shape through changes in policies and funding that emphasize the value of preventive services. Additionally, the transition of care from high-cost settings like hospitals to low-cost settings like outpatient facilities and homes will continue.
According to Johnson, technology can focus on industry prevention, care management and health promotion.
“We are increasing our ability to identify diseases sometimes three to four years before diseases appear, through the signaling of blood biometric screens, devices and other things.
5. Regulators and lawmakers continue to advocate for price transparency.
The new administration, encouraging consumers, is expected to continue to drive price transparency, which is likely to affect patient behavior and the healthcare revenue cycle.
Transparency is key to reforming payment models and reducing management costs and reducing management costs, according to Kusserow. This includes the challenges of prior approval and rejection of claims, which have contributed to rising prices.
“What we really need to do is real transparency, we need to understand the value of what people are buying,” he said.
Want to know more about what you can expect in 2025? Read about Guidehouse's 2025 Trends Guide for Trends Read on for insights into what providers, payers, government agencies and life science companies are planning for the year.
