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Healthcare consulting services for payers and providers
Healthcare is at a turning point. Costs are rising, consumer expectations are shifting, and technology is opening new doors. For executives ready to act, there’s real opportunity for you to build smarter, more connected, and more affordable systems of care. At PwC, we work with payers and providers to reimagine what’s possible — from unlocking AI’s potential to managing total cost of care and strengthening consumer trust. We can move healthcare forward together.
Radical change requires resilience and reinvention. We predict 10 sector dynamics that will require organizations to watch closely and act quickly in 2025. These dynamics, led by rising medical costs and consumer affordability challenges, are redefining the meaning of value creation in healthcare. It's time for organizations to create business models capable of delivering a healthier future for their business and those they serve.
Health plans and systems have a clear opportunity: Address affordability head-on and turn every shift — technology, regulation, deals or disruption — into a step toward lower long-term costs, greater health equity and stronger capabilities for value-based care.
Payers and providers still have room to accelerate — by embracing digital business models that connect functions, care settings and stakeholder experiences more seamlessly than ever. Underlying this shift is the need for better insights, analytics, cloud architecture and modern foundational administrative technology.
The quest to attract and retain members or patients is pushing payers and providers to invest in capabilities that engage earlier, sustain that engagement, boost accessibility to services and ultimately improve patient care — highlighting the need for improved marketing, relationship and engagement management.
As health service organizations continue to get larger, more regulated and more consumer facing, they need to up their game by anticipating, understanding and controlling their risks in compliance, finance, operations and technology.
Healthcare executives need to face workforce shortages with a focus on attracting and retaining talent in a more agile and tech-enabled workplace.
Deal value is shifting toward companies focused on primary care, home health, patient-facing tech, data platforms and digital innovation. At the same time, we’re seeing continued consolidation and divestitures of non-core assets as organizations refine their strategies.
The health services industry continues to evolve quickly with private equity, new business models, consolidation and consumer preferences all impacting legacy payers and providers. To stay competitive and lead, organizations need to activate every growth lever, from those that secure their place today to those that position them to win tomorrow.
For many health services companies, outdated operations and operating models stand in the way of true transformation — but that’s where the opportunity begins.