Payers reflect on 2025

This year was like a pitch-black roller-coaster ride for some payers.

Execs told Healthcare Brew at the end of 2024 they were planning for Medicare Advantage (MA) challenges in 2025 and were keeping their eyes on managing the costs of pricey specialty drugs.

What those providing government plans didn’t know was they’d kick off 2026 MA enrollment during a government shutdown. Nor did they all accurately predict just how much medical costs would rise in 2025. All that came while they faced a public reckoning and amped up their use of AI.

Healthcare Brew asked executives at leading insurance companies, plus outside experts, what they feel defined this turbulent year.

These answers have been lightly edited for length and clarity.

Amy Flaster, chief medical officer, the Cigna Group

In 2025, we advanced our commitment to improving health experiences for patients, their families, and the communities we serve. This guides much of our work and will continue into 2026 and beyond. We made progress on simplifying access to care—streamlining prior authorization, leveraging AI to connect people quickly to preventive services like flu shots, and enhancing digital tools that provide clear, personalized support and health navigation.

Ratnakar Lavu, chief digital information officer, Elevance Health

The most important development for payers this year has been the strategic integration of AI. We are working to transform healthcare by simplifying and personalizing experiences and improving health outcomes through technological innovation.

Alexis Levy, senior partner, HealthScape Advisors

2025 was defined by the continued challenges and financial pressures facing plans in the MA market. These financial pressures are driven by multiple factors, including increased utilization and regulatory changes that have made successful performance in star ratings and risk adjustment more difficult. Due to this challenging environment, plans are pulling back on their products, markets, and benefits, with some making the difficult decision to exit MA entirely. Plans have also engaged in other strategies to tamp down enrollment, including ending broker commissions and decreasing marketing support for certain products.