Healthcare has been undergoing many changes over the past decade, from the implementation of new technologies, advances in treatment and continual digital transformation. There is also the issue of ever-increasing spending and value for money. As a share of Gross Domestic Product, healthcare spending stands at over 17 percent—almost $14,000 per year for every person in the U.S.
What does 2025 have in store? Considering matters from the perspective of the U.S. market-based system is Jake Pyles, CEO of CipherHealth.
Focusing on patient-centered communications, CipherHealth works with hospitals and healthcare systems including Norton Healthcare, Advocate Health, and Prisma Health).
Value-Based Care Adoption Across the Maturity Spectrum
According to Pyles: “While traditionally led by progressive health systems, value-based care (VBC) is now being embraced by more “middle-of-the-pack” organizations, catalyzed by content management systems (CMS) and initiatives like the TEAM payment model (all in one purchasing and spend). In 2025, expect this trend to grow as healthcare providers across the board, regardless of their previous VBC readiness, recognize the need to move beyond fee-for-service models.”
As to the significance: “This shift signals that VBC is no longer an optional pathway but a requisite for sustainable, quality care across healthcare settings.”
The Rise of Employer Direct Models
On new deliver models, Pyles opines: “Employer direct care models, championed by organizations like Transcarent and Collective Health, are creating a new healthcare landscape where quality and cost-effectiveness are prioritized directly at the employer level.”
And as to the year ahead: “In 2025, as more employers recognize the need to ensure value-driven care for their employees, health systems will face growing competition from these employer-oriented networks. This trend will press providers to match quality and cost metrics, rethinking how they engage with employers as key stakeholders in population health.”
Empowered Patients: The Shifting Provider-Patient Dynamic
On the subject of users of healthcare, Pyles says: “Patients today come to healthcare settings with more information and a clearer sense of their own needs, often harnessing technology to better understand and manage their health. This shift is transforming the traditional provider-patient relationship and pressing health systems to engage patients more deeply at every stage of their care.”
This leads to the prediction: “In 2025, systems that succeed in meeting patients’ expectations will embrace tools that support shared decision-making, provide tailored guidance, and foster a proactive approach to health. For the industry, this means adopting technologies and strategies that respect patients’ evolving role as active participants, ultimately enhancing satisfaction and loyalty.”
