The State of the Industry Heading into 2025:
Recalibrating from topline growth to sustainable margins
The healthcare industry is in a period of recalibration. Organizations are revisiting how they prioritize topline growth relative to their ability to secure sustainable margins, pivoting their business strategies accordingly – and altering the traditional power dynamics and relationships within our industry.
To navigate this strategic environment, it is critical for leaders to sort structural forces from the temporary. The chaos of an election year, coverage churn, and procedure volume fluctuations distract from deeper structural shifts in the fragmenting policy environment, tightening payment updates, and unsustainable utilization trends.
Beyond this frenzied landscape, growing business pressures are causing organizations to pivot their strategies in two specific arenas:
- The future of hospital services: Regional hospital systems are navigating a fragile legacy business model and must chart a future strategy that is realistic for their local demand trajectory, competition, and capabilities. Partner organizations, from purchasers to suppliers, must prepare for variation in local community care delivery tactics and sustainability.
- Care delivery network design. Purchasers, plans, and providers alike are re-evaluating their approach to network design and participation. Many look to fragment their networks to cull their worst-performing partners, while some are redoubling efforts to build networks that stand up to such scrutiny through targeted, selective partnerships.
As healthcare organizations pivot strategy to get to sustainable margin performance across these arenas, their choices will determine how power dynamics play out at a market-level.
Attendees will learn about:
- State-federal policymaking outlook
- Insurance coverage and payment trends
- Projected utilization patterns
- Financial outlook and key growth competencies for regional hospitals
- Medicare Advantage headwinds
- Payer-provider contracting relationships
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