Healthcare finance trends for 2025: accelerating change.

For a more in-depth analysis of 2025 healthcare financial trends, find our full trends report here.

Healthcare leaders enter 2025 facing a host of pressing imperatives. They need to promote sustainable financial health, address patient affordability and financial experience, strengthen cybersecurity, unleash the benefits of technology innovation, and drive real progress on transforming healthcare’s entire delivery model.

Healthcare Finance Trends for 2025 by CommerceHealthcare^® presents the bank’s annual assessment of influential forces driving the current leadership agenda. This year’s report captures eight major themes across four planning sectors:

• Financial.
• Patient financial experience.
• Technology.
• New paradigms.

1. Financial conditions improving, but structural issues cloud outlook.

2024 followed 2023’s positive trajectory on key financial measures. But what is the outlook for 2025 and beyond? One CFO survey found that 60% believe operating margins will increase, 36% see them staying flat, and 4% expect a decrease.^[1] However, many express concern over intractable problems.

Leaders are also apprehensive about national economic and market pressures:

• Healthcare cost escalation.
• Shifting insurance mix.
• Labor shortages.
• Implications of new drugs.

Proposals and a change in national administration have generated substantial uncertainty about the direction of major health insurance programs. Changes are contemplated for Medicaid and Medicare Advantage that carry potential gains and losses for providers, but several amendments to the Affordable Care Act (ACA) marketplace have been advanced that healthcare organizations worry may have negative financial and care access impact.

2. More care will shift sites to power growth and control costs.

Sustained revenue growth and a viable cost structure are the motivations for the shift of care to a variety of non-hospital sites in recent years. That migration will continue to feature prominently in 2025 strategies, with three key growth vectors.

• Outpatient services.
• Virtual care.
• Hospital-at-Home.

3. Emphasis on capturing value from growing investment in finance technology.

A survey found that 75% have increased spending on digital health solutions over the past two years,^[2] however, leadership frustration with technology progress is mounting. A 2024 analysis estimated over $8 billion annually in cost increases from IT technologies that engender inefficiencies, delayed care, data breaches and other issues.^[3]

Investments are showing great promise in healthcare finance. Three technologies will stand out in 2025:

• Process automation. This low-hanging fruit frees staff from myriad repetitive tasks to concentrate on higher-level work. Automation also enhances capture of consistent quality data and streamlines payments infrastructure.
• Artificial intelligence. AI is being explored to improve finance and RCM.
• Digital payments. These are reaching a point of urgency for many.

4. Patient financial assistance expanding to maintain revenue streams and improve access to care.

Americans continue to face significant affordability problems that are exacerbated by healthcare cost inflation and greater self-pay obligations. The average individual employee is spending over $1,100 annually out-of-pocket.^[4]

Payment plans with longer durations and larger dollar amounts should be offered. Offering such flexibility necessitates that many organizations turn to external financial institutions to help scale programs. Zero interest rate lines of credit are also proven mechanisms.

5. Better patient financial experience an ongoing mission.

Robust patient financial assistance programs foster another vital goal: improving the end-to-end patient experience. Thirty percent of consumers say affordability is “most important to their healthcare experience.”^[5] Older adults with low financial resources are “less satisfied with the health care system, giving lower grades to providers.”^[6]

6. Cybersecurity a major overhang.

Security risks will continue to consume leadership attention throughout 2025. A few statistics:

• In 2024’s third quarter, healthcare averaged 2,434 attacks per week, up 81% over last year’s same period.^[7]
• 67% of healthcare organizations experienced ransomware incidents through August 2024. Over one-third of the demands exceeded $5 million.^[8]
• Healthcare has the costliest data breaches among all industries, with the average incident now standing at $9.77 million.^[9]

Newer or growing areas of vulnerability include:

• Medical devices. Devices are now being targeted as a major opportunity to disrupt clinical operations.
• Payments fraud. Online payments fraud is estimated to generate worldwide losses of $362 billion between 2023 and 2028.^[10] In a recent study, 65% of respondents reported that checks are the most susceptible method for fraud.^[11]
• Misinformation and “malinformation.” Healthcare is engaged in counteracting efforts to undermine consumer knowledge. Gartner predicts that “by 2028, enterprise spend on battling malinformation will surpass $500 billion, cannibalizing 50% of marketing and cybersecurity budgets.”^[12] 

7. M&A and creative partnerships further industry consolidation.

The M&A outlook for 2025 and beyond is fairly robust. Academic medical centers have emerged as particularly active buyers. They’ve targeted struggling rural and community hospitals that offer a channel for the academic center to alleviate its overcrowding issues and expand patient access.^[13]

Several current challenges complicate the M&A landscape:

• Transaction changes
• Questioning of cost impact
• Heightened regulatory scrutiny
• Competition from private equity

Meaningful alliances between healthcare systems and other entities represent a viable alternative to M&A in many instances and innovative partnerships are proliferating.

8. Growing impetus for new care and business models.

Many stakeholders see bolder moves to replace legacy care delivery and business models with truly transformative ones as essential to meeting the demands of 21^st-century. Four core elements are believed to be fundamental to the new model.

• Value-based. There is a long history of CMS initiatives promoting value-based care (VBC) to replace the fee-for-service paradigm.
• Need-based. This approach would proactively “leverage a suite of technologies to predict, identify, and communicate specific data to clinicians to decide how and when to intervene.”^[14]
• Tightly integrated. Today’s digital front doors are evolving to “digital corridors” that orchestrate “all aspects of the healthcare ecosystem, providing consistent care across devices and platforms and seamless interactions and handoffs.”^[15]
• Personalized. This path substantially alters the care relationship and represents the ultimate patient-centricity.

Conclusion.

The roadmap is clear though challenging to follow. It involves harnessing the trends in this report to put the organization on a sustainable financial footing, help patients with their growing payment obligations, and make effective enterprise-wide use of technology. Simultaneously, new core administrative and clinical models must be nurtured. The through line is change. Leaders will need allies for this ambitious agenda, and CommerceHealthcare^® is committed to helping providers navigate it successfully.

CommerceHealthcare^® solutions are provided by Commerce Bank.