5 Big Ideas From AHIP 2025 That Will Change Healthcare for the Better
By Sohail Djariri
The AHIP 2025 conference brought forward groundbreaking insights that will reshape the future of healthcare for stakeholders.
Whether you see yourself as a payer, provider, member, or patient, you will be affected by the programs, solutions, and ideas shared at this conference. Many of us fall into one or more of these groups, so understanding where the industry is heading is not only important to our work, but to our everyday lives.
From the rapid integration of AI-driven healthcare to the continuing emphasis on health equity and the importance of chronic disease prevention for people of all ages, healthcare leaders discussed and proposed innovative solutions to these long-standing challenges and many others.
5 Big Ideas to Improve Healthcare
AHIP 2025 underscored the continuing, positive shift in the healthcare landscape, setting the stage for a more efficient, member-centered system driven by tech-enabled solutions guided by healthcare experts.
If there was a single concept behind many of the ideas expressed at the event, this is it: Technology when you want it; people when you need them.
My top five takeaways from AHIP 2025 reflect this important concept:
- AI & Analytics Are Driving Transformation—But Execution Matters
AI was on everyone’s lips. It’s not just a buzzword; it’s an urgently needed operational enabler.
But attendees acknowledged that AI alone won’t solve the industry’s challenges or improve the member experience. When we humanize AI, the technology serves health plans, providers, and members while reducing abrasion between each group. To reach this goal, health plans are actively evaluating how AI can automate repetitive tasks, augment decision-making in utilization management and care management, and enhance the member experience through more personalized interactions.
Industry leaders stressed that AI initiatives must be governed by and aligned with the organization’s strategic initiatives. Many emphasized the need for practical, compliance-friendly AI use cases to demonstrate clear ROI.
AI hype will no longer work.
- Payers Prioritizing Value-Based Care & Behavioral Health Integration
One clear theme was the industry’s efforts to strengthen value-based care (VBC) models, expand access to behavioral health, and integrate physical and mental health services to improve member outcomes and reduce costs.
Attendees expressed a strong need for scalable behavioral health support, digital mental health solutions, and trusted partners who can bridge care gaps and offer practical solutions.
Success stories highlighted the need for intentional, collaborative payer-provider models to realize the promise of VBC.
- Medicare Advantage Under Scrutiny
Discussions centered on policy shifts impacting health plan Star Ratings, risk adjustments, and access to services by beneficiaries.
Speakers emphasized the continuing need to balance fraud prevention—Medicare Advantage (MA) made improper payments of $19.07 billion in 2024—and preserving MA program value.
Rising healthcare costs, intensifying enforcement of overpayments by CMS, slowing market growth, and health plans exiting the business altogether are muddling the MA market for those plans that remain.
- Holistic Health Approaches Expanding
Sessions on social determinants and “Food as Medicine” were well-attended and demonstrated how plans are addressing care beyond the clinical setting to improve equity and health outcomes.
There’s a continuing need to help members address care beyond traditional clinical settings, including integrating non-medical “treatments,” such as housing, nutrition, and community support. Each can improve health equity and improve member outcomes when using a holistic approach.
- Heightened Focus on Member Experience & Flexible Operations
Payers continue to rank member experience at the top of their strategic priorities list—driven by the need to elevate Star Ratings, meet retention goals, and improve competitive differentiation. Member contact center inefficiencies remain top of mind, while the desire to increase the number of digital self-service options—member portals, chatbots, texting—continues to grow. At the same time, there’s broad interest in flexible outsourcing models that balance cost savings with high-touch services.
The Way Forward
Those of us who are part of the healthcare industry are also part of a defining moment in innovation that emphasizes the growing synergy between technology and human expertise.
As healthcare continues its shift toward a more efficient system, I’m looking forward to seeing how we can better streamline processes, personalize care, and enhance accessibility.
I believe the prevailing theme for healthcare—no matter where we end up in the future—must be one where technology serves as an enabler or support system, not a replacement for humans. We’ll find that the best technology innovations are those that empower healthcare professionals to help provide compassionate, informed care.
Sohail Djariri is Chief Growth Officer at Sagility.