Healthcare DIVE October 13, 2025
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The growing challenges facing payers
Healthcare payers are grappling with a perfect storm of financial and operational pressures as national health spending surged by 8.2% in 2024, with a projected 7.1% increase in 2025, according to the Centers for Medicare & Medicaid Services (CMS). These challenges threaten profitability and the ability to deliver value, driven by unsustainable medical expenditures from rising chronic disease prevalence, costly treatments, pharmaceuticals and an aging population. Additionally, administrative inefficiencies—spanning prior authorizations, claims processing and customer service—are straining resources and driving up costs, further complicating operations in an increasingly complex healthcare landscape.
In addition, unpredictable regulatory changes make it difficult for payers to plan ahead and maintain financial stability. There...
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