As healthcare providers look toward 2025, preparing for new policy changes will demand a proactive and informed approach. New regulations will cover many critical areas, including the push for streamlined financial operations and affordability, improved data interoperability, increased security, and enhanced patient privacy.
As healthcare providers look toward 2025, preparing for new policy changes will demand a proactive and informed approach. New regulations will cover many critical areas, including the push for streamlined financial operations and affordability, improved data interoperability, increased security, and enhanced patient privacy.
It’s set to be a landmark year for healthcare, and staying updated with the latest tools and processes is critical—especially given the mounting administrative and clinical demands on providers’ time. Preparing for these advancements allows practices to align with policy shifts and demonstrate a commitment to patient-centered care and operational efficiency.
Below, we’ll explore some of the key policy changes in healthcare for 2025 that providers will need to be prepared for.
Financial and Insurance Policy Changes Likely Hitting Healthcare in 2025
Site-neutral Payment Policies
Due to growing bi-partisan interest, many experts are predicting that Medicare will continue to press forward on site-neutral payment policies, such as those seen in the Lower Costs, More Transparency Act. While proponents believe these changes will help lower overall healthcare costs, detractors argue that they may decrease hospital revenue to an extent that threatens the operations of rural hospitals. While the new policy isn’t a guarantee, it’s something providers should be aware of to prepare for this potential new financial reality.
Changes to Prior Authorization Requirements
Prior authorizations are a major headache for providers. They can drain an immense amount of time, and in some cases delay patient care. A CMS rule taking effect in 2026 will require many payers to respond to urgent prior authorization requests within 72 hours, and regular requests within seven days—which previously took up to a month. It will also require a reason to be submitted with denials, helping to expedite the resubmission process.
Many states have already passed additional legislation to help regulate prior authorizations, a trend that many policy experts believe is likely to continue in 2025 and beyond. These changes are designed to help healthcare providers reduce their administrative burdens and devote more focus to their patient’s care.
Growing Bi-partisan Support for Antitrust Legislation in Healthcare
From many perspectives, there appears to be growing support for slowing down the trend of major mergers and acquisitions within the healthcare sector. While some feel consolidation has been a boon for financially struggling facilities, others believe that increasingly large health groups are creating a lack of competition that drives up patient costs. This coincides with increasing skepticism over the influence of private equity firms in healthcare, and will likely result in policy advancements over the next year or several years.
Cyber Security Will be a Major Policy Focus in Healthcare
Ransomware attacks in healthcare have been on the rise. The Change Healthcare cyber attack, which resulted in a major data breach and months of financial tumult for healthcare providers, brought even more attention to the critical need for policy advancements in this area.
In early 2024, The U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR) and the National Institute of Standards and Technology (NIST) published a new version of guidance for regulated healthcare entities to follow, “Special Publication (SP) 800-66 Revision 2,” and in July, the Healthcare Cybersecurity Act was introduced to further work toward a more secure ecosystem for patients and providers.
These are likely just the first of many upcoming actions and new regulations. You can find more information in our recent blog post, “The Future of Healthcare Cybersecurity—What You Need to Know About New Regulations.”
Innovation Will Continue to Drive Healthtech Policy Forward
Telehealth’s Continued Expansion
Since the COVID-19 pandemic, telehealth has continued to rise, with visits increasing from 5 million in 2020 to 53 million in 2022 — and that number is expected to grow at a CAGR of 23.8% by 2030. For most providers, telehealth is a mainstay, providing practices with much-needed flexibility and convenience.
With continuous policy support encouraging adoption in mental health, chronic care, and preventative services, telehealth is poised to continue growing. Legislative support has also focused on expanding telemedicine access, which should make virtual healthcare more accessible to rural and underserved communities.
Increasing Use of Artificial Intelligence (AI) for Enhanced Diagnostics and Efficiency
AI has already transformed the healthcare industry in numerous ways. In 2025, AI integration is set to play a more significant role, with the global AI healthcare market projected to grow by $199.8 billion by 2028. As AI adoption grows, these tools will assist providers in everything from diagnostics to patient care management and administrative efficiency. For example, AI can enhance diagnostic accuracy through advanced imaging analysis, which could help providers detect conditions like cancer earlier, ultimately improving patient outcomes.
AI will also streamline administrative tasks, reducing time spent on scheduling, billing, and documentation. For healthcare providers, AI integration in 2025 means faster, more accurate diagnoses and a smoother workflow that allows clinicians to focus more on patient care. Investing in these tools helps healthcare practices meet policy requirements, stay competitive, and deliver high-quality care.
Predictive Analytics and Personalized Medicine at The Forefront
Predictive analytics, powered by AI, allows healthcare providers to identify patients at risk of specific health issues and offer preventative care options. For example, by analyzing a patient’s genetic data, medical history, lifestyle factors, and environmental influences, predictive tools can help forecast a patient’s risk of developing specific diseases.
In 2025, as predictive analytics become more widely used, healthcare providers can expect to offer more precise and proactive care, moving beyond reactive treatments to a model focused on prevention and early intervention. This shift, combined with a growing emphasis on data interoperability, will empower providers to make data-driven decisions that align with patient needs and emerging healthcare policies.
Remote Patient Monitoring (RPM) will Become More Common
Remote patient monitoring (RPM) is reshaping how chronic diseases and post-surgical recovery are managed. For example, wearable healthcare devices — like smartwatches — and mobile apps allow providers to monitor patient data in real-time, enhancing the management of conditions such as diabetes, hypertension, and cardiovascular diseases.
In 2025, healthcare policies will likely continue to support RPM to reduce hospital readmissions and improve patient outcomes, especially as cost-saving measures become more critical for the healthcare system.
Data Interoperability: Smoother Exchange Between Providers
Data interoperability and the Internet of Medical Things (IoMT) are increasingly intertwined as both are crucial for seamless data sharing and enhanced patient monitoring. Going into 2025, as more IoMT devices like wearable health monitors, connected glucose sensors, and smart inhalers become standard in patient care, interoperability will be essential to ensure these devices can communicate effectively with various healthcare systems. According to one study, the IoMT market is expected to grow at a rate of 20.4% from 2023 to 2030, reaching nearly $668.07 billion by 2030.
The integration of IoMT with interoperable data systems allows for data sharing among healthcare providers, which can lead to faster diagnoses, more coordinated care, and improved patient outcomes. For example, a patient’s wearable device data can be seamlessly transmitted to their provider’s electronic health record (EHR) system, allowing for timely interventions and more personalized treatment plans.
With more policies focused on interoperability going into 2025, healthcare providers can expect enhanced reporting capabilities and improved care coordination, creating a more connected and data-driven healthcare ecosystem.
Adapting to 2025: Navigating Changes and Staying Ahead
As healthcare providers prepare for the policy and technological advancements of 2025, adopting the right tools can make all the difference in staying competitive and compliant. That’s where RXNT comes in. RXNT offers a full suite of healthcare software solutions designed to support practices in adapting to these shifts — from telehealth and remote monitoring integrations to EHR and practice management that simplify workflows and enhance data connectivity.
Ready to see how RXNT can help your practice stay ahead of upcoming changes and deliver patient-centered care? Request a demo today.
