The recent U.S. election has had profound implications for the healthcare industry, prompting industry leaders to reexamine their strategies and day-to-day operations. At the Miami Herbert Business School’s annual “The Business of Health Care” conference on January 24, 2025, a pivotal forum brought together stakeholders across key sectors—home care, hospital systems, payors, and others—to assess the election’s impact and chart a path forward. The conference highlighted the need for collaboration, innovative solutions, and strategic leadership in addressing the challenges ahead.

The speakers emphasized the need for collaboration across the healthcare spectrum to harness technological advancements, ensure sustainable healthcare financing, and address systemic challenges like provider shortages and public trust, with four key areas for potential change:

1. Deploying Artificial Intelligence Solutions: The administration has made funding and supporting AI technology development a priority, and AI has the potential to achieve significant administrative efficiencies and cost-savings for payors, health systems and providers. It can also contribute to developing novel drug therapies, support public health surveillance, and drive new clinical treatment modalities to support physicians. It may also help to reduce discrimination in claims processing, ensuring fairer results for patients regardless of race. However, the conference also underscored the challenges of integrating AI into health care. Valid data and clinician oversight are essential to ensure that AI systems enhance human judgment rather than replace it, particularly in pre-authorization decisions. The speakers stressed the importance of balancing technological innovation with the preservation of medical expertise to ensure equitable and effective outcomes.
2. Ensuring Sustainability for Medicare Advantage and ACA Policies. The oldest Baby Boomers are starting to reach 80 years of age, and the U.S. population will continue to age at a rapid pace in the coming decades. Our country’s healthcare spending is unsustainable at current pace, and value-based care solutions will be necessary to provide patients with timely access to needed care. In addition, dealing with obesity and other co-morbid conditions (e.g., hypertension, diabetes mellitus, heart failure, arthritis, etc.) requires a multi-faceted approach and collaboration among payors, providers, and the government. In strategizing about potential solutions, the panelists identified the following critical action items: controlling pharmacy costs (including via pharmacy benefit manager regulation), providing access to preventative care and early-stage interventions, having healthcare payments be consistent across various sites-of-service, and expanding the use of and access to hospice for patients at the end of their lives. Early-stage interventions and preventative care were emphasized as cost-effective strategies to improve outcomes while managing resources effectively. These value-based initiatives represent a necessary shift to meet the demands of an aging and increasingly complex patient population.
3. Solving for Provider Shortages, Particularly in Rural Areas. Along with an aging population, the U.S. is also grappling with widespread provider shortages, particularly in rural parts of the country, and provider burnout with physicians, nurses, and other clinical roles across the industry. The conference highlighted several strategies to address this issue, including financial incentives to attract providers to underserved areas and workplace violence prevention programs to improve working conditions for nursing staff. The panelists also highlighted that the number of medical school graduates working on the administrative side of health care has increased significantly in recent years, with lower numbers of practicing clinicians available to render care. In terms of potential solutions, the panelists highlighted that AI support may help alleviate some of the stressors, as would efforts to reduce provider burnout. The panelists also highlighted the need to make clinical work – particularly in rural areas – attractive for physicians from a financial standpoint. Finally, they identified the adoption of team-based care strategies, alone or in conjunction with value-based care solutions, is a potential way to solve for the challenges to access and timely care caused by the shortages. The speakers also emphasized the adoption of team-based care strategies, which can alleviate pressure on individual clinicians and improve the efficiency of care delivery. By fostering collaboration among healthcare professionals, team-based models can help bridge gaps in access and address the growing demand for services.
4. Bolstering Public Trust in Science and Institutions. The erosion of public trust in science and healthcare institutions, exacerbated by the COVID-19 pandemic and political polarization, was another pressing issue discussed. Patients’ concerns about cost, access, and claims challenges have fueled frustration, making it critical for healthcare leaders to foster transparency and combat misinformation. The panelists noted that patients have genuine concerns with respect to access, cost, and claims challenges. In addition, the fragmenting of information from social media may negatively influence patients’ opinions and attitudes toward providers. The biggest concern is that in response to another pandemic or major issue like widespread antibiotic resistance, there may be insufficient support and funding for science-based solutions. While that is a significant concern, the panelists noted that many of them are actively engaging with and educating the administration on potential policy initiatives, their outcomes, and hoping to support the strength of those institutions and their ability to respond in a crisis. The panelists noted the importance of actively engaging with communities and policymakers to address these issues and rebuild confidence in the healthcare system. They stressed that public trust is essential not only for managing future crises, but also for advancing systemic reforms that benefit all stakeholders.

The Miami Herbert Business School conference underscored the importance of strategic collaboration and adaptive leadership in addressing the healthcare industry’s most pressing challenges. As highlighted throughout the discussions, sectors such as home care, hospital systems, and payors must work together to harness AI, implement value-based care, and address workforce shortages while fostering public trust.

By prioritizing innovation, equity, and transparency, healthcare leaders can navigate these challenges and build a more efficient, sustainable, and resilient healthcare system for the future. The lessons and insights from this pivotal forum offer a roadmap for turning challenges into opportunities and delivering meaningful progress for patients, providers and payors alike.