Top Healthcare Trends in 2025: What Self-Funded Employers Need to Know

In 2025, global healthcare costs are expected to rise 10.2%, up from 9.3% in 2024. With health benefits ranking as the top priority for employees—42% of whom prefer better health insurance over a pay raise—self-funded employers will face increasing pressure to manage rising costs without passing them onto their workforce. 

The healthcare landscape is rapidly evolving, driven by technological advancements, changing consumer behaviors, and shifting regulations. For self-funded employers, these changes present both opportunities and challenges in managing employee health benefits. As we look ahead to 2025, several healthcare trends are set to reshape how employers design their benefit plans and navigate healthcare delivery. 

Telemedicine and Virtual Care Expansion

Telemedicine has become a major trend, with its full potential still unfolding in healthcare. By 2025, virtual care is expected to become a core component of most healthcare plans. The adoption of telehealth services surged during the COVID-19 pandemic, and its convenience and cost-efficiency have made it a preferred choice for many employees seeking routine care, mental health services, and follow-up consultations. 

For self-funded employers, integrating telemedicine into their benefit offerings could reduce healthcare costs. Virtual care allows employees to access primary care, mental health support, and specialist consultations without leaving home. This not only saves time but also reduces the need for more expensive in-person visits. This can lead to lower claims costs, improved employee satisfaction, and a healthier workforce. 

Employers will need to ensure that telemedicine is included in their plans. Either as a standalone service or integrated with traditional in-person care. They also should monitor utilization trends to ensure telemedicine enhances care coordination and is used effectively. The Alliance’s Smarter Networks^SM incorporate virtual and independent providers to ensure access to timely, cost-efficient care. These customizable networks enable employers to optimize savings by directing plan participants to preferred-value providers, while maintaining a wide range of choices.  

Data-Driven Healthcare and Predictive Analytics

The use of big data and predictive analytics in healthcare is revolutionizing how health outcomes are managed. By 2025, it’s expected that self-funded employers will rely more heavily on data-driven solutions to optimize their healthcare plans. Predictive analytics can help employers identify high-risk employees early. This enables them to take preventive measures that could reduce future healthcare costs. 

Data analytics tools can track health trends, monitor chronic conditions, and predict the likelihood of certain health events, such as hospital admissions or surgery needs. With this information, self-funded employers can intervene proactively with tailored wellness programs, targeted health interventions, and lifestyle management initiatives. For instance, a program could be designed to help employees with diabetes better manage their condition, potentially preventing costly complications. 

The Alliance helps its employer-members access and understand their data with Smarter Health^SM analysis, a customized healthcare analytics report that provides data-driven insights, which drive significant savings. When employers identify where healthcare dollars are being spent, they can pinpoint opportunities to guide plan participants to preferred-value providers. This facilitates cost savings without compromising the quality of care.     

Mental Health and Wellness Focus

Mental health has increasingly become a focal point of health benefits in recent years. By 2025, it will be an integral part of employee healthcare plans. The pandemic brought mental health challenges to the forefront, and companies are beginning to realize that a mentally healthy workforce is just as important as a physically healthy one. Mental health challenges, such as stress, anxiety, and depression, can significantly impact employee productivity, engagement, and overall well-being. 

Investing in mental health resources can lead to better retention rates, reduced absenteeism, and increased productivity, ultimately benefiting employers’ bottom lines. So, self-funded employers will need to adapt their benefits offerings to provide comprehensive mental health services. This includes access to therapy, counseling, and digital mental health tools. The rise of teletherapy platforms, mindfulness apps, and online support groups will give employees better access to mental health support.  

AI and Automation in Healthcare

Artificial intelligence (AI) and automation are set to play a significant role in healthcare by 2025. AI technologies are improving healthcare efficiency and cost-effectiveness by automating tasks and analyzing medical data for accurate diagnoses.

But personalized healthcare means more than just precision medicine. It’s about tapping into the power of AI and data to address every aspect of a patient’s unique needs. Think of tailored wellness plans and communication strategies aimed at encouraging hard-to-reach demographic groups to engage with healthcare providers. This helps push health provision away from reactive to preventative measures – reducing cost burden and improving patient outcomes. 

For self-funded employers, AI can help identify patterns in healthcare data, allowing employers to offer tailored health interventions and services to employees. For example, if a high number of employees are seeking care from emergency departments, employers can offer incentives for going to a primary care provider (PCP).  

Value-Based Care and Payment Models

By 2025, self-funded employers will increasingly turn to value-based care (VBC) models as a way to control healthcare costs while ensuring that employees receive high-quality care. Under value-based care, providers are reimbursed based on patient outcomes rather than the volume of services provided. This shift from fee-for-service models aligns employers, employees, and providers to focus on better health outcomes at lower costs.

Employers adopting value-based care contracts will collaborate with providers to ensure coordinated, preventive care focused on improving health. By emphasizing prevention, early intervention, and evidence-based treatments, employers can reduce unnecessary procedures and hospital admissions, leading to substantial savings. To achieve this, self-funded employers will need to educate employees about the benefits of value-based care and how they can participate in their own care management.  

Looking Ahead: Healthcare in 2025

As we move into 2025, employers will need to navigate a rapidly changing healthcare environment. Trends including virtual services, data-driven care, mental health focus, artificial intelligence, and value-based care will shape the future of employee health benefits. To stay competitive and cost-effective, self-funded employers must stay ahead of these trends, leveraging the tools and technologies that are revolutionizing the healthcare industry. By doing so, they can improve employee health outcomes, reduce costs, and create a more engaged and satisfied workforce.  

Reach out to us to learn how we can help you revolutionize your health benefits for your employees and their families.