How a new administration will accelerate changes in healthcare

Please note: This webinar was recorded in early February 2025. There may be developments, especially in the political arena, that affect the perspectives shared during the presentation. 

Significant changes were expected for healthcare in 2025—and then the election happened. 

A new presidential administration and Congress are expected to disrupt the healthcare industry to promote efficiency and whole-person care. The government has already made sweeping changes to public health policy, healthcare regulation, and provider reimbursement—with more to come.  

During a recent webinar, Guidehouse Partner David Burik, leader of the Center for Health Insights, sat down with David Johnson, CEO of 4sight Health, and Paul Kusserow, chairman and former CEO of Amedisys, to discuss what healthcare leaders can expect in the year ahead. The panelists discussed the market forces that will make 2025 a pivotal year for the healthcare industry and shared why they think healthcare will change more in the next 10 years than the last 100. 

Watch the 2025 Healthcare Outlook webinar below and read our recap below to learn how to prepare your organization for these changes.  

Five key takeaways

1. To reduce costs, the healthcare industry needs to address administrative burden.
In 2025, the healthcare system continues to grapple with high administrative costs, which account for as much as one-third of total healthcare expenditure. This burden is largely due to the fragmented nature of the system and the complex interactions between payers and providers. 

"We have a very disjointed system that requires various handoffs from a clinical perspective as well as a financial perspective,” Kusserow said. “That has just created enormous cost in the system, enormous fragmentation, which has produced suboptimal care and also very expensive care." 

While technology has the potential to streamline administrative processes, it cannot fix a broken system on its own. In 2025, fundamental changes in payment models and care delivery are necessary to reduce administrative costs.

2. Changes to reimbursement models could have a profound impact on efficiency.
"We are not fundamentally going to change the way we deliver care until we change the way we pay for it,” Johnson said. The evolution toward value-based care, supported by technology, is expected to create a more rational relationship between administrative costs and care delivery in 2025.

The shift to full risk contracting and capitation is gaining momentum, as these models reward reduction in administrative costs and improvements to care delivery. But the current fee-for-service model contributes to inefficiency and high costs. Addressing these challenges requires a comprehensive approach that includes payment reform, enhanced care coordination, and education to help patients make the right choices, both in navigating care and maintaining their health. 

“As the payment models evolve and the tech supports it, we can begin to have a more rational relationship between administrative costs, which should be far, far less,” Kusserow said. “The administration sees there's tremendous waste there and they're targeting extremely large numbers.”  

3. Consumers will force unprecedented change in healthcare.
Healthcare consumerism will be stronger than ever, as digital health platforms give consumers more tools to manage their care and the Trump administration advocates for more consumer choice in healthcare decisions, an effort that is expected to materialize through a focus on transparency and cost-effective care. 

Value-based reforms can be advanced by educating consumers and providing them with tools that help them navigate the healthcare system in a cost-effective manner that benefits their health, Kusserow said.

"We need to teach people how to consume health,” Kusserow said. “We need to allow the strength of consumerism to really play hard here, because Americans are the best consumers in the world, but in healthcare they're the worst, because it's almost impossible to figure out." 

4. 2025 will be the year of whole-person care. 
The Trump administration has repeatedly expressed a desire to focus on whole-person care, a position that is expected to take shape through policy and funding shifts that emphasize the value of preventive services. In addition, the migration of care from higher-cost settings like hospitals to lower-cost settings such as outpatient facilities and the home, will continue. 

Technology will enable the industry’s increased focus on prevention, care management, and health promotion, Johnson said. 

"We are getting an increasing ability to identify illness far earlier in pre-disease stages, at times three to four years in advance of when the disease manifests, through biometric screens of blood, signaling of devices, and other things—and then using artificial intelligence to look for small changes or patterns, and then correlate that with the onset of chronic disease.” 

5. Regulators and legislators will continue to advocate for price transparency.
Emboldened by consumers, the new administration is expected to continue to push for price transparency, which is likely to impact patient behavior and the healthcare revenue cycle. 

Transparency is key to reforming payment models and reducing administrative costs because it brings increased scrutiny to what is driving higher costs, Kusserow said. That includes challenges with prior authorizations and claims denials that are contributing to inflated prices.

“What really needs to be done is there needs to be true transparency—true understanding of the value of what people are buying,” he said.

Want to learn more about what to expect in 2025? Read Guidehouse’s 2025 Trends Guide for insights into what providers, payers, government agencies, and life science firms are planning for the year ahead.