Pumpkin spice lattes have made way for turkey and stuffing, and now we find ourselves in a season of ugly sweaters, pop star Christmas albums, and special moments. For working professionals, this is a time for looking ahead and making predictions about what might change in their industry in the new year. End-of-year predictions offer timely reads as people wind down and take a break from their daily work.

Unveiling the Unlikely Shifts in Healthcare in 2025

GLP-1 Access: A Complex Puzzle

GLP-1s have emerged as miracle drugs in recent years, with clinical studies showing great promise. The class of drugs has been a boon for pharmaceutical firms, seeing a more than 400% increase in spending from 2019 to 2023 among Medicaid populations. The Biden Administration's recent move to expand access to GLP-1 drugs among Medicaid and Medicare beneficiaries has added to the excitement. However, thorny problems persist. The rapid increase in demand has led to shortages, with some pharmacies and virtual care companies producing non-FDA approved but legal drugs. Zach Reitano, Founder and CEO of Ro, a virtual care company, emphasizes the need to address basic issues like lowering treatment costs and overcoming access barriers. Sean Duffy of Omada, a digital health company, warns that while GLP-1s are promising, their impact may be temporary and they need to be paired with proper lifestyle changes.

Provider Consolidation: A Persistent Trend

Horizontal mergers, vertical acquisitions, and cross-market mergers are on the rise. Between 2005 and 2022, the share of community hospitals in multi-hospital systems increased from 53% to 68%, and the share of physicians practicing in hospital-owned practices rose to 41% in 2021. Scott Barclay, Managing Director at Insight Partners, sees relationship dynamics with health plans driving hospital self-interest. Graham Gardner, MD and CEO of Kyruus Health, focuses on the strain on relationships with consumers as more people age into Medicare. The multiple factors driving provider consolidation, such as administrative challenges and competition, make it unlikely to slow down in 2025.

Generative AI in Healthcare: Hype vs. Reality

A Flare Capital report shows $30 billion invested in healthcare AI in the past five years, and an Andreesen Horowitz analysis suggests it can unlock $314 billion in more efficient healthcare operations. Generative AI seems to be finding its place in certain use cases like ambient scribe technology. However, there is skepticism about its actual application in real-world healthcare environments and the ability to scale successful AI-first businesses. David Schweppe, Chief Analytics Officer of MedeAnalytics, believes generative AI is not the answer to everything. Robin Glass of Included Health emphasizes the importance of using AI to build on the human connection at the center of health.

Retail and Tech in Healthcare: A Wait-and-See Approach

When Tim Cook announced Apple's potential impact on healthcare in 2019, it sparked speculation. Five years later, Apple has not achieved the expected impact. Industry insiders are skeptical, and even Harvard Business Review doubts disruption from corporate outsiders. Sean Duffy of Omada expects Amazon to be the only major corporation truly committed to transforming care delivery. The failed initiatives and investments from big tech and retailers have raised doubts.

Data Interoperability: A Slow but Steady March

“The politics of access to healthcare data will continue as if it’s a 6th grade student council election,” says Jonathan Bush, CEO of Zus Health. There are ongoing difficulties in consumer access to their data and disputes between companies like Oracle Health and Epic Systems. Alon Joffe, Cofounder and CEO of Eleos Health, agrees that while all stakeholders want interoperability, progress will be slow. Nick Stepro of Arcadia describes the complexity and incentives involved. Despite the challenges, there is a sense of movement, and Jonathan Bush is optimistic about emerging financial incentives.

Antitrust in Healthcare: Keeping a Close Eye

The incoming Trump Administration is likely to focus on antitrust policy in healthcare. Speculation abounds about its stance on private sector competition. The DOJ's antitrust case against Google was initiated under the previous administration, and there are ongoing investigations into UnitedHealth Group and pharmacy benefit managers. Nick Stepro of Arcadia points to the issues affecting health data interoperability as barriers to innovation. FTC Chairperson Lina Khan is aware of the Particle Health lawsuit, and Assistant Attorney General Jonathan Kanter emphasizes the need to assess broader changes in business.

A Case for Rational Optimism

Given the relatively little expected change in healthcare in 2025 and the system's challenges, why be optimistic? Alon Joffee of Eleos Healthcare believes we live in the best time to impact the system with technological tools. Scott Barclay advises taking a longer-term view. Darren Brandt of Sloane PR reminds us that healthcare takes time and patience. Working to improve healthcare can be a challenging task, but sometimes keeping a steady course is the key.