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Open Up The Hood: Payer Financial Modernization at HLTH 2025

Publisher IDC
Published Dec 03, 2025
Length 8 Pages
SKU # IDC20635549

Description

This IDC Perspective summarizes the quotes and opinions around payer financial modernization at the HLTH 2025 conference, which was held October 19-22, 2025, in Las Vegas.Because of AI technology, particularly agentic AI, payers are refocusing on financial systems' stability and financial seamless impact after years of experimentation. At HLTH 2025, some technologies were presented that may cause a rethink of core administration."Regarding new core administration technologies, a key question is how feasible seamless core administration and interoperable data are at the point of care, given the current provider workflows, interoperability challenges, and siloed incentives — we will see," says Jeff Rivkin, research director at IDC Health Insights.

Table of Contents

8 Pages

Executive Snapshot

Situation Overview

Revenue Cycle and Claims Adjudication Revival

The Problem

Agentic to the Rescue

Intelligent Prioritization and Auto-Adjudication

Adaptive Claims Operations

Implementations

Alternative Payment Models Continue to Loom

Centene

Blue Cross Blue Shield of Michigan

Risant Health (Kaiser + Geisinger)

Arbital Health

Security Concerns

Advice for the Technology Buyer

Providers

Payers

Value-Based Care

Learn More

Related Research

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