Top 5 Marketing Challenges Facing Healthcare Payers in 2025—And How to Navigate Them
The healthcare payer landscape in the United States looks markedly different today than it did five years ago. Not only did the COVID-19 pandemic upend healthcare as we know it, but patients across all age brackets now also have more medical needs than previous generations. At the same time, healthcare organizations are under immense pressure to deliver a modern digital experience while also safeguarding patient data.
As healthcare organizations plan for the future, it’s important to have a clear picture of the present landscape and keep an eye on emerging trends. We recently ran an analysis of the state of healthcare payer marketing in 2025, and reviewed our findings with Aaron Mauck, Managing Director of Healthcare Strategy at Endeavor, to get his take.
In this article we’ll break down the key findings from our research and share Aaron’s insights on how healthcare organizations can survive and thrive in the current landscape.
Five major challenges for payers in today’s healthcare landscape
In the current market, healthcare organizations are tasked with delivering a superior experience while also navigating complex regulatory and financial pressures. The healthcare landscape is certainly becoming more competitive, but as patient needs increase there will also be more opportunity for growth. Here are five key obstacles that healthcare payers must navigate to win member trust.
1) A shifting population pyramid
As the United States demographic evolves, healthcare organizations face unique challenges across multiple age brackets. While it’s no surprise that older populations have greater medical needs, the Baby Boomer generation, now entering the 60-80 year-old age bracket, is notably larger than the preceding Silent Generation. As a result, healthcare organizations will face a greater number of patients carrying complex care needs than in recent years. Furthermore, modern care standards will likely increase these patients' longevity, therefore requiring care for a longer period of time.
But the aging population is not the only demographic putting strain on the healthcare system. Gen X and Millenial patients, now aged 29-60, are currently sicker than those age groups have been in the past. Increased chronic diseases such as obesity and diabetes, as well as new behavioral health needs, are resulting in greater healthcare demands. Although we now have effective ways to treat these complex conditions, modern treatments are expensive, resulting in rising healthcare costs per capita. Gen Z patients are certainly healthier than older demographics, but they too have new behavioral health needs that healthcare organizations will need to support.
2) Greater financial pressure on healthcare payers
Healthcare activity dropped significantly during the COVID-19 pandemic, as many patients deferred elective procedures due to safety concerns. This respite offered healthcare payers an opportunity to buy up new resources, reinvest, and redevelop strategy.
As the country recovered from the pandemic, however, pent up demand led to a spike in healthcare activity, which has continued at consistent levels since. Patient utilization rates are now higher than they have been in recent years, resulting in an increase in insurers’ Medical Loss Ratio (MLR)—defined as the share of total health care premiums spent on medical claims and efforts to improve the quality of care.
“The increase in Medical Loss Ratio signifies much more pressure than we’ve seen in the past for insurers. They’re going to have to do more, as we see demand going up, with less. Expect things to become more competitive, and expect consumers to have strong needs that you’re going to have to figure out a way to meet,” explained Aaron.
3) Decreased confidence in the healthcare system
Public confidence in the medical system declined significantly between 1975 and 2018, from 56% to 36%. And this trend likely only continued throughout the COVID-19 pandemic, with public health expert and healthcare executive Dr. Leana Wen noting that “The COVID-19 pandemic left many questioning the integrity and transparency of the systems they once trusted."
It’s worth noting, however, that patients continue to hold high levels of trust for the individuals that deliver point-of-care healthcare services, such as doctors (84%) and pharmacists (78%). As healthcare marketers look to build trust, many are utilizing the ‘humans’ within their organizations to connect with patients.
This challenge is particularly complex for organizations that don’t offer direct patient services, such as insurers. As Aaron explains, “Insurance is really separated from point-of-care. You don’t go to a brick-and-mortar insurer. Insurers, if anything, run into these public trust challenges even more than other parts of the healthcare system. They have to worry about very strong pressures on public trust at a time when their financial situation is becoming a little bit more tenuous.”
4) Increased regulatory activity
Consumers’ growing mistrust in healthcare organizations has manifested itself in outside pressures. One of the most prominent is scrutiny of healthcare data management. In recent years we’ve seen a notable uptick in media coverage of healthcare privacy leaks and data mismanagement. Concurrently, we’ve seen over 200 class action lawsuits filed and $145M in HIPAA penalties across 152 enforcement actions. Healthcare marketers can expect regulatory supervision to continue in the near future.
5) Increased patient expectations
While consumers are becoming more sensitive to healthcare data management, however, they’re also demanding higher quality experiences than ever before.
Modern consumers are able to access exactly what they need, when they need it. Missing an ingredient while making dinner? Get it delivered in minutes. Running late for a flight? Have a personal driver at your door in seconds. As these frictionless experiences have become ubiquitous, they’ve also become an expectation. Consumers today demand services across all industries to be seamless and personalized, regardless of whether or not those industries are digitally-native.
This development presents a challenge for healthcare marketers, who will need to provide patients with a modern consumer experience while also supporting the strict data regulations unique to healthcare. As Aaron describes, “we want to be able to deliver that experience to consumers, and they’re right to ask for it. But we need to think about a strategy that allows us to meet those needs without fostering mistrust. How do you get the quality of Uber without the risk?”
How are marketers reacting to these pressures?
To adapt to these pressures, our research shows that many healthcare marketers are shifting away from traditional investments such as radio and out-of-home advertising and increasing investment in digital channels. Platforms such as Facebook Ads and Google Ads enable healthcare marketers to deliver tailored experiences that meet modern consumer expectations while also measuring ROI.
As healthcare marketers increase investment in digital channels, they also develop more sophisticated digital programs. Healthcare organizations with smaller budgets, defined in our research as under $50k in monthly spend, focus primarily on converting high-intent patients through bottom-of-funnel channels like Google Ads. As organizations increase their digital budget, they improve ROI by adopting a full-funnel approach, leveraging top-of-funnel channels, such as Display, to increase brand awareness, and middle-of-funnel channels, such as paid social, to drive engagement. Leading Cincinnati-based provider St. Elizabeth’s for example, was able to achieve a 92% improvement in conversion volume by bolstering conversion campaigns with additional digital programs throughout the funnel.
This shift to digital programs also increases the risk of healthcare privacy violations, however. Recent Freshpaint research uncovered that only 24% of surveyed organizations are "fully aware and have taken proactive measures" regarding privacy. Furthermore, 75% of surveyed healthcare marketers are aware of the risks of using PHI for advertising but have yet to implement a data privacy solution.
So what should healthcare marketers do?
For healthcare marketers to deliver digital programs that are viable in the long run, they need to implement a solution that provides balance between privacy and performance.
The way in which organizations find that balance is based on their unique risk profile. At the conservative end of the spectrum, organizations may remove all risky technology and stop digital advertising completely. This will significantly reduce the risk of HIPAA violations, but also stunt growth. At the other end of the spectrum, organizations zealous for growth may not implement any restrictions at all, unblocking advertising but increasing regulatory risk.
As marketers look to find the right balance for their team, we’d advise taking a privacy-first approach to high-performance marketing, ensuring responsible data management while also supporting growth. Aaron explains, “the key way to approach this is to understand compliance as a growth enabler rather than a growth constrainer. Recognize that privacy has to be the foundation of a long-term growth strategy. Compliance is not optional, it should foster growth rather than constrain it in your approach.”
The first step to developing your privacy-first approach is to assess your current data privacy standing. Here are five steps for getting started:
- Audit - Create an inventory of all third-party tracking activities on your websites and apps.
- Analyze - Determine if PHI is being disclosed through those trackers.
- Verify - Ensure any PHI disclosure is permissible under HIPAA.
- Govern - Govern the flow of data to non-compliant tools to ensure PHI is not being disclosed.
- Monitor - Continuously monitor your sites and apps for new trackers.
Implementing a privacy foundation for growth
The foundation of a privacy-first approach to high-performance marketing is a reliable healthcare privacy platform. By implementing a privacy infrastructure that allows you to protect patient information while also powering personalized campaigns, you can deliver fuel growth without compromising on patient privacy.
Leading healthcare payers trust Freshpaint as their privacy-first marketing foundation. Healthcare marketers use Freshpaint to track the user information they need and control what gets sent downstream to third-party tools, making it possible to deliver modern, data-driven marketing campaigns with their favorite tools while also safeguarding PHI. If you’re ready to implement a privacy foundation for long-run growth, you can connect with our team today.
