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PUBLISHER: IDC | PRODUCT CODE: 1883320

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PUBLISHER: IDC | PRODUCT CODE: 1883320

Open Up The Hood: Payer Financial Modernization at HLTH 2025

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PAGES: 8 Pages
DELIVERY TIME: 1-2 business days
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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.

Product Code: US53914025

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
  • Synopsis
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