Healthcare payers are making big investments in analytics, AI, and digital transformation with the goal of translating data into bottom line efficiencies and improved member experiences.
For many payers, however, system integration, staffing, and improved data quality are needed to fully translate analytics investments into the operational gains they are seeking.
Those are among the key findings of our 2025 Payer Market Survey, gleaned from data and Milliman MedInsight analytics users at payer organizations ranging from approximately 50,000 to 2 million members.
Their responses paint a picture of the industry’s growing expectations that analytics will yield new capabilities for protecting operating margins, improving member care and heightening competitive advantage.
But while expectations are high, the results also show that less than two-thirds of our survey respondents believe they are currently getting what they need from their analytics.
What’s driving payer analytics investment and what’s blocking results
Overall, the findings make it clear that payers view analytics as essential to organizational performance, particularly for cost and utilization management, quality and outcomes measurement, risk adjustment, and value-based care.
At the same time, respondents cite meaningful obstacles that limit their ability to fully capitalize on data and analytics. Other key findings include:
- Margin pressure is the #1 transformation catalyst: 36% cite improved operating margins as a primary digital transformation objective.
- Cost and utilization analytics leads the definition of “success”: 72% rank it as most linked to success, followed by quality/outcomes measurement (59%) and risk adjustment (51%).
- AI/GenAI potential is clear but scaling stalls at integration: 64% cite legacy-system integration as the biggest barrier to enterprise-wide AI/GenAI adoption.
To learn more about Milliman MedInsight solutions for healthcare payers, including analytics for identifying cost drivers, improving risk adjustment and provider network management, contact a member of our team.
