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As 2024 unfolded, healthcare organizations faced a rapidly shifting landscape—embracing advanced technologies, navigating regulatory complexities, and doubling down on member retention strategies. Throughout the year, HealthAxis delved into these challenges and opportunities, sharing insights that resonated across the industry.
In today’s rapidly transforming healthcare landscape, health plans face mounting pressures to balance operational demands, cost efficiency, and member satisfaction. While artificial intelligence (AI) and automation offer promising solutions, many payers remain hesitant and uncertain about their practical applications and benefits. However, specific technologies like conversational AI and robotic process automation (RPA) are proving their value, creating a foundation for smarter decision-making, significant cost reductions, and deeper member engagement—all without compromising care quality.
In Part 1 of this two-part series, we examined the top five technology areas receiving increased investment from healthcare payers in 2025, according to the 2025 Gartner CIO and Technology Executive Survey. Now, we turn to the next set of high-priority investments aimed at further optimizing payer operations.
The healthcare payer industry is at a pivotal moment. As operational costs rise, consumer expectations evolve, and technology rapidly advances, payers are compelled to reassess their technology priorities to stay competitive and ensure they can scale efficiently while addressing complex regulatory and operational demands. According to the 2025 Gartner CIO and Technology Executive Survey, several key areas are emerging as top investment priorities, all aimed at boosting efficiency, enhancing patient outcomes, and optimizing operations.
Welcome to the third edition of our blog series, Open Enrollment Readiness: Expert Insights from HealthAxis. This series is designed to provide health plans with actionable insights and expert advice to navigate the complexities of the open enrollment period successfully.
Welcome to the first installment of our blog series, Open Enrollment Readiness: Expert Insights from HealthAxis. This series provides health plans with actionable insights and expert advice to navigate the complexities of the open enrollment period successfully.
Welcome to the first installment of our blog series, Open Enrollment Readiness: Expert Insights from HealthAxis. This series is designed to provide health plans with valuable real-world insights and practical advice as they prepare for the critical open enrollment period. Our thought leaders at HealthAxis will share their expertise on key areas that can make or break your open enrollment success.
The healthcare industry faces a constant challenge: balancing rising costs with the imperative to deliver high-quality care. Prior authorization has become a crucial tool for payers, helping to ensure medical necessity and control spending. However, the current process is often bogged down by administrative complexities, creating a burden for both providers and patients.
Member retention is paramount in a competitive healthcare landscape. A classic Harvard Business Review study revealed that a mere 5% increase in customer retention can boost profits by 25% to 95%. This statistic underscores the critical role satisfied members play in the financial stability and success of healthcare payers and third-party administrators (TPAs).
In Part One of this series, we examined the initiatives Gartner identified as key areas for acceleration,1 following their extensive evaluation through research surveys and interactions with U.S. healthcare payer business and technology executives.