The New Era of Healthcare:
Predictions and Implications for What Lies Ahead
by Kimberlee Schardin, CAE, MBA and Elizabeth Schumacher, JD
As we reflect on 2024, it’s clear that the healthcare landscape has transformed faster than ever before. Rapid advances in technology, shifting reimbursement models, and evolving patient expectations have reshaped everything as we know it.
With these advancements and shifts come challenges that healthcare providers must successfully navigate to continually thrive in this ever-changing, dynamic environment. Medical and healthcare associations have a unique role to lead innovation to solve for these challenges.
2024 revealed a complex set of both opportunities and obstacles. From AI development to regulatory burdens needing common sense solutions, healthcare associations thought leadership can develop the right change. All of this indicates the hurdles and paves the way for strategic innovations to help propel healthcare in the future.
Below are five of the top issues that shaped healthcare in 2024. Each of these that will have significant impacts in 2025 and beyond. These issues have led to relevant predictions for how associations will need to continue to evolve, grow, and collaborate to improve the future.
- Reimbursement and Regulatory Barriers
A primary challenge for providers will be reimbursement structures and continued evolutions there, creating financial strain and administrative complexity distracting from the main goal of patient care. On top of reimbursement challenges, regulatory burdens also absorb both time and resources that could otherwise be spent on delivering quality patient care.
This ongoing transition of reimbursement structures from fee-for-service to value-based care, is where providers were rewarded based on patient outcomes rather than the volume of services rendered. While value-based care promises often to result in better patient outcomes, the reimbursement model often leaves providers struggling to predict revenue streams and complex payment structures.
Key implications, include: 1). more physicians selling their practices to private equity due to too many financial burdens, and 2). reimbursement rates from government programs (like Medicare and Medicaid) remain low, which puts further strain on the system leading to burnout as they seek to balance quality care with the overall needs of the practice longer term.
- Access to Care and Growth of Specialized Medicines
Access to care is a big issue we will continue to deal with. Particularly relevant is access to specialty drugs, which has presented significant hurdles for healthcare providers, burdening them with soaring administrative tasks and creating barriers to patient care. Increasingly high costs associated with specialty medications, such as those for rare diseases or advanced cancer treatments, have such burdensome insurance preauthorization processes for patients and providers that many patients seek alternative ways to fund their care and to receive the best access. These administrative strains also delay treatment initiation, which, for patients often means the difference between stabilization and disease progression.
Healthcare associations have a huge role in drug development innovation and educating their members about the best and newest treatments. As new therapeutics emerge, the lack of accessible information can make it challenging for providers to stay informed about their effectiveness, potential side effects, and insurance coverage options. Rapidly evolving drug options can also lead to some exciting positive outcomes for patients.
Key Implication: As a result, these issues around access to and development of specialty medications not only hinders providers’ ability to deliver the very best care, but also indicates the need for more transparent, supportive systems to alleviate the burden on providers and improve medication accessibility.
- The Future of AI in Healthcare
Everyone in healthcare is talking about AI and its impact on healthcare now and in the future. AI can be used in limitless applications, but we are also seeing changes in many areas, including but not limited to, 1). treatment planning, 2). diagnostics, and 3). patient care. As AI adoption rises, so will the problems to solve such as issues as data security and ethical issues. AI systems rely heavily on vast amounts of sensitive patient data, making cybersecurity paramount. Cyberattacks, data breaches and patient privacy are a few questions about how AI systems safeguard data and comply with regulations like HIPAA.
Healthcare association thought leadership is necessary to ensure we leverage AI to the fullest. Healthcare associations should lead in developing and advising in new solutions and also educating members and colleagues in how to adapt AI and its effects. As AI develops, so do the algorithms which have a huge impact on equality in patient outcomes. AI models are trained on existing healthcare data, which may reflect historical biases, particularly in underrepresented communities. For instance, if an AI tool is trained on data from predominantly affluent populations, it may not accurately assess health risks for other demographics, leading to disparities in diagnosis and care. Medical association thought leadership is crucial to ensure health equity improves.
Key Implication: AI has the potential to greatly improve healthcare equity for everyone if developed correctly. Healthcare associations can play a valuable role in optimizing AI to leverage better care in millions of ways, but an important area may include eliminating biases by collaborating with AI developers and ensuring that the information is inclusive and accurate. Healthcare thought leaders will need to continually review AI outcomes, ensuring that all are treated equally and constantly adjust systems to improve fairness.
- Behavioral and Mental Health Crisis
Behavioral and mental health challenges have emerged as an ever-growing and pressing public health crises, affecting millions worldwide. Patients often face a lack of accessible, stigma-free care, exacerbating chronic conditions and compounding daily stressors. Healthcare providers experience significant strain as they attempt to meet the growing demand for mental health services without adequate resources or support, making mental health a top priority not only in healthcare, but for healthcare providers. This creates a cycle where patients and professionals both are left vulnerable, limiting the effectiveness of treatment and overall health outcomes. Many healthcare associations have quickly adapted to this need since COVID, leveraging their association to also serve as important community to its members. Associations should lean more into the community convening role they play, supporting members in many ways from providing benefits they want and need both personally and professionally.
Key implications, include: 1) reducing the stigma surrounding mental health, 2). expanding access to care, and 3). integrating behavioral health services into primary care settings. Providing education on emerging therapies, new delivery models, and holistic treatment can empower healthcare systems to better serve patients. Promoting collaborative models, public awareness initiatives, and expanded mental health services will help to foster compassionate, inclusive, and accessible support for all.
- Healthcare Workforce Shortages
Workforce shortages in healthcare are a huge hurdle that significantly impacts both patient care and the well-being of healthcare providers. Overburdened teams are stretched thin, struggling to meet patient needs while facing high workloads, growing distrust in medicine and burnout. Healthcare association thought leadership can help develop best frameworks for interdisciplinary care teams, leveraging the right providers to provide the right care to patients. Associations can lead the way by offering specialized certifications and advanced training to allow the entire care team to provide care at the top of their license. The entire healthcare system will need to continue supporting rural and urban underserved communities, where access to services is limited, leaving many without timely treatment. The increasing demand for healthcare services, coupled with the aging population and high attrition rates among providers, only deepens this problem, putting more pressure on an already overtaxed workforce.
Key implication: Healthcare providers play a pivotal role in shaping solutions by actively participating in efforts to address these shortages. This includes mentoring new entrants into the field, advocating for policy changes that expand training opportunities, and engaging in initiatives to reduce burnout and leverage care teams. By working collaboratively with industry partners, educational institutions, and policymakers, providers can help create a more resilient workforce that meets patient needs, enhances care quality, and fosters a sustainable and supportive healthcare environment.
At the end of the day, all these healthcare trends – whether an opportunity or an obstacle – are important as they ultimately impact what healthcare will look like over the long term and how it will continue to evolve in 2025. Predicting the future is undecidedly difficult, but healthcare associations can play a sustainable role in helping to shape positive outcomes by leading and implementing several of the implications we’ve shared.
“Everybody is innovative by nature. This is especially true of healthcare workers. The core part of my role is to empower people to voice their ideas and then create a safe space for them to further explore and evaluate their ideas.”
– Omkar Kulkarni, chief innovation officer, Children’s Hospital Los Angeles
