Healthcare Coverage: Followed Money & Friction – PYMNTS 2025 Analysis

by Marcus Liu - Business Editor
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But across 2025,PYMNTS’ 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.

Early-year coverage framed the business backdrop. PYMNTS reported that digital health venture funding 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.

In a January interview, Manatt Health’s Jared Augenstein described 2025 as “the year of evidence,” saying that HealthTech firms would need to demonstrate clinical impact and measurable ROI to remain viable.

PYMNTS data added texture to the demand side, where the digital shift is in evidence.

The PYMNTS Intelligence report “The Digital Healthcare Gap: Streamlining the Patient Journey” found that two-thirds of consumers use patient portals, and older cohorts are not necessarily digital holdouts. “The Digital Platform Promise: What Baby Boomers and Seniors Want From Digital Healthcare Platforms” revealed that baby boomers and seniors reported high satisfaction with receiving test results online and meaningful participation in digital healthcare activities.

The takeaway is that digital adoption is broadening,## AI’s Ascent in Healthcare: 2025’s key Developments

Artificial intelligence (AI) continued its rapid integration into healthcare throughout 2025, moving beyond pilot programs and demonstrating tangible impacts on clinical trials, patient experience, and consumer costs. Here’s a look at some of the year’s defining moments.

AI-Powered Clinical Trials & The Rise of Digital Twins

One of the most meaningful advancements centered on the request of AI in clinical research.Unlearn founder Jon Walsh told PYMNTS in June that the goal is not incremental betterment but a re-architecture of clinical research. The company has spent seven years earning regulator confidence, positioning digital twins as a way to reduce reliance on placebo groups and accelerate trials.

In one of the year’s most concrete examples of AI meeting the patient experience, Weave announced in May its acquisition of TrueLark to automate scheduling and front-office interaction.

Weave Chief Operating Officer Marcus Bertilson 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.

By the Numbers: Consumer Costs

The consumer angle in 2025 was anchored by PYMNTS Intelligence’s Generational Pulse findings, which repeatedly linked digital care adoption to financial strain and payment friction.

Midyear reporting showed telehealth’s mainstream status among young consumers, but also highlighted the financial hurdles many face when accessing care. 7 in 10 Gen Z consumers reported finding paying for healthcare a headache, according to PYMNTS data.

Healthcare Payments in 2024: A Year of Digital Conversion and Generational Strain

The intersection of finance and healthcare continued to intensify in 2024, marked by a surge in telehealth adoption and a growing focus on modernizing patient payment experiences.However, this digital transformation is colliding with significant financial pressures, notably for younger generations.

A recent report highlighted how economic pressures are impacting healthcare access across generations, with a disproportionate effect on Gen Z. Specifically, a study found that 80% of Gen Z reported that healthcare costs strained their budgets, leading many to delay or forgo necessary medical care. This is despite having insurance, as high premiums, deductibles, and out-of-pocket expenses present a significant barrier to access for those in early career stages.

The Digital Delivery vs. Payment Disconnect

While telehealth has become increasingly popular, offering convenient access to care, the underlying payment systems haven’t kept pace.A PYMNTS analysis in July revealed that many providers still rely on outdated digital payment systems, creating friction for patients, especially Gen Z. This disconnect between the digital delivery of care and the frequently enough-clunky payment process is becoming a critical issue.

Modernizing billing and payment workflows is no longer simply a back-office improvement; it’s a competitive necessity. Patients now expect the same seamless and immediate payment experiences they encounter in retail and banking.

Key Areas of Focus in healthcare Finance

Throughout 2024, several key areas emerged as focal points within the healthcare finance landscape:

* Prior Authorization: Streamlining the often-complex prior authorization process remains a significant challenge.
* Claims Processing: improving the efficiency and accuracy of claims processing is crucial for both providers and payers.
* Cost-Smoothing tools: Health plans are increasingly incorporating tools to help patients manage and predict healthcare costs.
* Consumer Payment Experiences: The demand for user-friendly and flexible payment options continues to grow.

For payments and FinTech executives, the overarching lesson of 2024 is clear: the success of digital transformation in healthcare hinges on the patient’s experience at the point of billing.

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