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Healthcare Leaders Prioritize AI and Payer Integration for Reimbursement Resilience

by Fred Pennic 10/03/2025 Leave a Comment

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What You Should Know: 

– A new survey conducted by Becker’s Healthcare and Net Health reveals that healthcare leaders are making strategic technology investments to ensure financial resilience amid ongoing regulatory and reimbursement shifts. 

– The survey, which polled 100 health system and hospital CFOs, finance VPs, and clinical technology leaders, highlights that leaders are concerned about payer integration challenges and view Artificial Intelligence (AI) as a key tool for boosting reimbursement, efficiency, and ROI.


Regulatory Uncertainty is Redefining Financial Stability

The concept of sustaining predictable revenue in the face of policy uncertainty is a major priority across health systems. While 42% of respondents expressed some level of optimism about possible changes to reimbursement policies under the new administration, significant concerns remain around:

  • Data privacy laws (28%).
  • Value-based care implementation (27%).
  • Interoperability mandates (26%).

Healthcare leaders expect technology solutions to ease the growing burden of compliance. The top three tech investment areas for the next year are Revenue Cycle Management (RCM) tools, compliance tools, and EHR upgrades.


Payer Integration Remains a Major Pain Point

Interoperability challenges, particularly with payers, continue to be a significant concern. Respondents reported changes to interoperability standards among their top three challenges in the upcoming year.

  • Integration Gap: While 48% of surveyed health system leaders report having full integration in their system, a majority (52%) admit their systems are only somewhat integrated with payers like Medicare, Medicaid, and insurance companies.
  • Needed Solutions: Tech buyers are actively seeking integrated solutions that improve both efficiency and security. Direct EHR billing integration and assistance with reimbursement are critical needs.

AI Adoption Hinges on Proving ROI

AI is viewed with optimism, but confidence is still forming. Only 49% of health system leaders surveyed see AI and advanced analytics as a solution for cost efficiency and ROI as it relates to reimbursement. Almost as many leaders remain unclear about AI’s potential, indicating that broader adoption will depend on vendors demonstrating clear ROI, ease of use, and regulatory safety.

For more information about the survey, visit https://www.nethealth.com/lp/technology-strategies-for-reimbursement/

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Tagged With: Artificial Intelligence, Revenue Cycle Management

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