{"id":385269,"date":"2026-01-01T19:03:14","date_gmt":"2026-01-01T19:03:14","guid":{"rendered":"https:\/\/www.newsbeep.com\/au\/385269\/"},"modified":"2026-01-01T19:03:14","modified_gmt":"2026-01-01T19:03:14","slug":"pymnts-2025-healthcare-coverage-followed-money-and-friction","status":"publish","type":"post","link":"https:\/\/www.newsbeep.com\/au\/385269\/","title":{"rendered":"PYMNTS\u2019 2025 Healthcare Coverage Followed Money and Friction"},"content":{"rendered":"<p>But across 2025, PYMNTS\u2019 reporting treated the sector less like a purely clinical domain and more like a sprawling, regulated marketplace where the hardest problems are administrative, financial and increasingly digital. The common thread was not a new gadget or a shiny app. It was the widening mismatch between how care is delivered and how it is paid for.<\/p>\n<p>Early-year coverage framed the business backdrop. PYMNTS reported that digital health venture <a class=\"editor-rtfLink\" href=\"https:\/\/www.pymnts.com\/healthcare\/2025\/10-1-billion-pours-into-digital-health-but-late-stage-ventures-feel-the-pinch\/\" target=\"_blank\" rel=\"noopener nofollow\">funding<\/a> reached $10.1 billion in 2024, down from the prior year but still above pre-pandemic levels. Late-stage companies faced tougher capital conditions and a renewed push toward consolidation and partnerships.<\/p>\n<p>In a January interview, <a class=\"editor-rtfLink\" href=\"https:\/\/www.manatt.com\/Health\" target=\"_blank\" rel=\"noopener nofollow\">Manatt Health<\/a>\u2019s <a class=\"editor-rtfLink\" href=\"https:\/\/www.linkedin.com\/in\/jaredaugenstein\/\" target=\"_blank\" rel=\"noopener nofollow\">Jared Augenstein<\/a> described 2025 as \u201cthe year of evidence,\u201d saying that HealthTech firms would need to demonstrate clinical impact and measurable ROI to remain viable.<\/p>\n<p>PYMNTS data added texture to the demand side, where the digital shift is in evidence.<\/p>\n<p>The PYMNTS Intelligence report \u201c<a class=\"editor-rtfLink\" href=\"https:\/\/www.pymnts.com\/study\/the-digital-healthcare-gap-patient-payment-portals-innovation\/\" target=\"_blank\" rel=\"noopener nofollow\">The Digital Healthcare Gap: Streamlining the Patient Journey<\/a>\u201d found that two-thirds of consumers use patient portals, and older cohorts are not necessarily digital holdouts. \u201c<a class=\"editor-rtfLink\" href=\"https:\/\/www.pymnts.com\/study\/the-digital-platform-promise-online-healthcare-doctor-appointment-prescriptions\/\" target=\"_blank\" rel=\"noopener nofollow\">The Digital Platform Promise: What Baby Boomers and Seniors Want From Digital Healthcare Platforms<\/a>\u201d revealed that baby boomers and seniors reported high satisfaction with receiving test results online and meaningful participation in digital healthcare activities.<\/p>\n<p style=\"text-align:center\">Advertisement: Scroll to Continue<\/p>\n<p>The takeaway is that digital adoption is broadening, but uneven, and the patient journey still breaks down at the financial step.<\/p>\n<p>AI Moved From Pilots to Production<\/p>\n<p>Interviews and analysis during the year documented a shift in healthcare artificial intelligence from experimentation to scaled deployment, with governance as the gating factor.<\/p>\n<p><a class=\"editor-rtfLink\" href=\"https:\/\/www.linkedin.com\/in\/aashimagupta\/\" target=\"_blank\" rel=\"noopener nofollow\">Aashima Gupta<\/a>, global director of healthcare strategy and solutions at <a class=\"editor-rtfLink\" href=\"https:\/\/cloud.google.com\/\" target=\"_blank\" rel=\"noopener nofollow\">Google Cloud<\/a>, told PYMNTS in an October interview that ROI in <a class=\"editor-rtfLink\" href=\"https:\/\/www.pymnts.com\/news\/artificial-intelligence\/2025\/healthcare-ai-roi-enters-era-scaled-high-stakes-growth\/\" target=\"_blank\" rel=\"noopener nofollow\">healthcare<\/a> is not only about efficiency but also about creating conditions for better care. She also warned against positioning AI as a clinician.<\/p>\n<p>Google Cloud research indicated that many healthcare and life sciences executives reported AI agents in production, and data privacy and security were central selection criteria.<\/p>\n<p>Several PYMNTS conversations focused on where AI is being aimed first. It\u2019s not at diagnosis, but at workflows that determine whether providers get paid and patients get answers. <a class=\"editor-rtfLink\" href=\"https:\/\/www.autonomize.ai\/\" target=\"_blank\" rel=\"noopener nofollow\">Autonomize AI<\/a> CEO <a class=\"editor-rtfLink\" href=\"https:\/\/www.linkedin.com\/in\/padmanabhan\/\" target=\"_blank\" rel=\"noopener nofollow\">Ganesh Padmanabhan<\/a> told PYMNTS in July that large language models make it possible to distill information from complex <a class=\"editor-rtfLink\" href=\"https:\/\/www.pymnts.com\/news\/artificial-intelligence\/2025\/autonomize-says-agentic-ai-accelerates-shift-from-sick-care-to-healthcares-true-potential\/\" target=\"_blank\" rel=\"noopener nofollow\">clinical documentation<\/a> and contextualize it for different workflows, exactly the kind of work that has historically resisted automation. The company\u2019s emphasis includes administrative processes, such as insurance approvals and patient communication.<\/p>\n<p>The same trust first theme appeared in a discussion about AI-powered digital twins. <a class=\"editor-rtfLink\" href=\"https:\/\/www.unlearn.ai\/\" target=\"_blank\" rel=\"noopener nofollow\">Unlearn<\/a> founder <a class=\"editor-rtfLink\" href=\"https:\/\/www.linkedin.com\/in\/jrwalsh1\/\" target=\"_blank\" rel=\"noopener nofollow\">Jon Walsh<\/a> told PYMNTS in June that the goal is not incremental improvement but a re-architecture of <a class=\"editor-rtfLink\" href=\"https:\/\/www.pymnts.com\/artificial-intelligence-2\/2025\/ai-powered-digital-twins-give-clinical-trials-a-75-year-upgrade\/\" target=\"_blank\" rel=\"noopener nofollow\">clinical research<\/a>. The company has spent seven years earning regulator confidence, positioning digital twins as a way to reduce reliance on placebo groups and accelerate trials.<\/p>\n<p>In one of the year\u2019s most concrete examples of AI meeting the patient experience, <a class=\"editor-rtfLink\" href=\"https:\/\/www.getweave.com\/\" target=\"_blank\" rel=\"noopener nofollow\">Weave<\/a> announced in May its <a class=\"editor-rtfLink\" href=\"https:\/\/www.pymnts.com\/healthcare\/2025\/weave-acquires-truelark-as-healthcare-front-desks-answer-ais-call\/\" target=\"_blank\" rel=\"noopener nofollow\">acquisition<\/a> of <a class=\"editor-rtfLink\" href=\"https:\/\/truelark.com\/\" target=\"_blank\" rel=\"noopener nofollow\">TrueLark<\/a> to automate scheduling and front-office communication.<\/p>\n<p>Weave Chief Operating Officer <a class=\"editor-rtfLink\" href=\"https:\/\/www.linkedin.com\/in\/marcus-bertilson-53a33b22\/\" target=\"_blank\" rel=\"noopener nofollow\">Marcus Bertilson<\/a> told PYMNTS that patients expect immediate answers, but still end up waiting on hold. Weave bets that the most scalable interface may not be an app at all, but the phone augmented by conversational AI.<\/p>\n<p>By the Numbers: Consumer Costs<\/p>\n<p>The consumer angle in 2025 was anchored by PYMNTS Intelligence\u2019s <a class=\"editor-rtfLink\" href=\"https:\/\/www.pymnts.com\/study\/?filter-type=series&amp;filter-items=generational-pulse&amp;page=1\" target=\"_blank\" rel=\"noopener nofollow\">Generational Pulse<\/a> findings, which repeatedly linked digital care adoption to financial strain and payment friction.<\/p>\n<p>Midyear reporting showed <a class=\"editor-rtfLink\" href=\"https:\/\/www.pymnts.com\/healthcare\/2025\/7-in-10-gen-zers-find-paying-for-healthcare-a-headache\/\" target=\"_blank\" rel=\"noopener nofollow\">telehealth<\/a>\u2019s mainstream status among young cohorts. PYMNTS cited survey results that found that roughly 30% of Generation Z and millennials used telehealth for their most recent visit, versus single-digit usage among baby boomers. Mental health stood out as especially virtual. But the reporting emphasized that nearly 7 in 10 Gen Z patients encountered payment issues, including limited digital payment options and insurance-related hassles.<\/p>\n<p>\u201c<a class=\"editor-rtfLink\" href=\"https:\/\/www.pymnts.com\/study_posts\/clicks-care-copays-how-each-generation-navigates-digital-healthcare\/\" target=\"_blank\" rel=\"noopener nofollow\">Clicks, Care &amp; Copays\u2014How Each Generation Navigates Digital Healthcare<\/a>,\u201d a June report, sharpened the \u201cexpectations gap.\u201d It found that payment barriers hit young generations hardest and that baby boomers were more likely to describe their last healthcare payment as easy. The implication for banks, payments providers and digital wallet players is that healthcare may be adopting digital care channels, but it still lacks consumer-grade financial plumbing.<\/p>\n<p>Late in the year, PYMNTS\u2019 Generational Pulse coverage turned to affordability. The November edition, \u201c<a class=\"editor-rtfLink\" href=\"https:\/\/www.pymnts.com\/study_posts\/economic-pressures-split-the-generations-as-each-rethinks-the-basics\/\" target=\"_blank\" rel=\"noopener nofollow\">Economic Pressures Split the Generations as Each Rethinks the Basics<\/a>,\u201d found that 80% of <a class=\"editor-rtfLink\" href=\"https:\/\/www.pymnts.com\/healthcare\/2025\/healthcare-costs-force-one-in-four-gen-z-to-skip-care\/\" target=\"_blank\" rel=\"noopener nofollow\">Gen Z<\/a> said healthcare costs strained their budgets, and sizable shares delayed doctor visits or skipped recommended tests due to cost. Insurance coverage does not eliminate the problem, as premiums, deductibles and out-of-pocket costs collide with early-career finances.<\/p>\n<p>Telehealth and Insurance Are Payments Stories<\/p>\n<p>If telehealth was the delivery narrative, billing was the business narrative. A July 4 PYMNTS analysis said that while care has gone <a class=\"editor-rtfLink\" href=\"https:\/\/www.pymnts.com\/healthcare\/2025\/telehealth-popularity-pressures-providers-modernize-patient-payments\/\" target=\"_blank\" rel=\"noopener nofollow\">digital<\/a>, payment systems often have not, pointing to widespread issues paying for care and elevated friction for Gen Z. As telehealth becomes routine, modernizing billing and payment workflows becomes a competitive requirement, not a back-office upgrade.<\/p>\n<p>By year\u2019s end, PYMNTS\u2019 healthcare beat read like a map of where finance and healthcare intersect, including prior authorization, claims processing, cost-smoothing tools embedded in health plans, and consumer payment experiences shaped by the same immediacy standards as retail and banking.<\/p>\n<p>For payments and FinTech executives, the core lesson of 2025 was that in healthcare, digital transformation succeeds or fails at the moment the bill arrives.<\/p>\n","protected":false},"excerpt":{"rendered":"But across 2025, PYMNTS\u2019 reporting treated the sector less like a purely clinical domain and more like a&hellip;\n","protected":false},"author":2,"featured_media":385270,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[34],"tags":[254,64,63,207,28241,137,500,1474,4631,44,6628,59749],"class_list":{"0":"post-385269","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-healthcare","8":"tag-artificial-intelligence","9":"tag-au","10":"tag-australia","11":"tag-digital-payments","12":"tag-featured-news","13":"tag-health","14":"tag-healthcare","15":"tag-innovation","16":"tag-insurance","17":"tag-news","18":"tag-pymnts-news","19":"tag-telehealth"},"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/posts\/385269","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/comments?post=385269"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/posts\/385269\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/media\/385270"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/media?parent=385269"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/categories?post=385269"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/tags?post=385269"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}