This report identifies key demand-side trends in the healthcare payer business process transformation space to help enterprises fine-tune their operations. It provides an overview of key observations and business challenges that Avasant considers important to highlight in the healthcare payer outsourcing space.
The healthcare payer business process industry is under intense pressure from rising costs, complex regulations, and growing consumer expectations for seamless, digital-first experiences. To remain competitive and address margin compression, payers are accelerating digital transformation by deploying AI, automation, and analytics to streamline operations, particularly in claims, prior authorization, and payment integrity. At the same time, there is a decisive industry shift from fee-for-service to value-based care models such as capitation, bundled payments, and pay-for-performance, which incentivize better outcomes, holistic care coordination, and member retention while minimizing costs.
The Healthcare Payer Business Process Transformation 2025 Market Insights™ aids organizations in identifying important market trends and expectations for any healthcare payer services projects that they engage in.
The industry insights presented in this report are based on the following: our ongoing interactions with enterprise CXOs and other key executives; targeted discussions with service providers, subject matter experts, and Avasant Fellows; analyst insights from primary and secondary research; and lessons learned from consulting engagements.
About the report (Page 3)
Executive summary (Pages 4–7)
Demand-side trends (Pages 8–12)
Key contacts (Page 13)
Read the Research Byte based on this report. Please refer to Avasant’s Healthcare Payer Business Process Transformation 2025 RadarView™ for detailed insights on the service providers and supply-side trends.
Avasant’s research and other publications are based on information from the best available sources and Avasant’s independent assessment and analysis at the time of publication. Avasant takes no responsibility and assumes no liability for any error/omission or the accuracy of information contained in its research publications. Avasant does not endorse any provider, product or service described in its RadarView™ publications or any other research publications that it makes available to its users, and does not advise users to select only those providers recognized in these publications. Avasant disclaims all warranties, expressed or implied, including any warranties of merchantability or fitness for a particular purpose. None of the graphics, descriptions, research, excerpts, samples or any other content provided in the report(s) or any of its research publications may be reprinted, reproduced, redistributed or used for any external commercial purpose without prior permission from Avasant, LLC. All rights are reserved by Avasant, LLC.
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