Health plan professionals and leaders gathered in Las Vegas earlier this month at AHIP 2025 and dug in on the biggest and most pressing issues in health care. This Special Report covers some of the main topics discussed at the conference. And, if you haven't yet, subscribe to AHIP Solutions SmartBrief and AHIP Health@Work SmartBrief to keep up with the latest health plan industry news.

What happened: Panelists at an AHIP 2025 session emphasized the need for a person-centered health care system that is driven by value and financially accessible. Keys to reducing risk factors and increasing access include prioritizing preventive care, integration of technology and partnerships among stakeholders. 

What's next: Implementation of value-based care, integration of data and deploying team-based delivery systems can boost patient outcomes, the speakers said. Addressing social determinants of health collaboratively and developing strategies to communicate why evidence-based care is important will help build trust with the public, according to the panelists. 

What they said: "It's time for us to get behind value-based care." -- David Brailer, chief health officer and chief technology officer of Cigna

Health care faces significant challenges, including the high cost of care in the US and poorer health outcomes compared with other high-income countries, writes Zameer Rizvi, founder and CEO of Odesso. True value-based care requires a coordinated approach that integrates patient history and long-term wellness strategies, Rizvi writes: "Health care shouldn't be a series of isolated visits with your doctor; rather, it should be a cohesive approach aimed at keeping you healthy in the long run."

What happened: David Fajgenbaum, cofounder and president of Every Cure and associate professor of medicine at Penn Medicine, shared his story at AHIP 2025 about being critically ill with Castleman's disease and his discovery that the drug sirolimus, an inexpensive and readily available treatment, could help him. His experience led him to start Every Cure, which uses AI to discover existing drugs that can be repurposed to treat other diseases. Kathy Giusti, cofounder of the Multiple Myeloma Research Foundation, was diagnosed with multiple myeloma at 37, and there were no treatment options at the time. Her challenges prompted her to start the foundation, which focuses solely on finding a cure for multiple myeloma. 

What's next: Fajgenbaum and Giusti both said health plans should explore ways to partner with patient advocacy organizations on effective patient navigation programs, along with investigating opportunities to share data to identify patients who could benefit from therapies. Engaging with the next generation of patients on early screening and managing genetic and familial health risks will also be important, they said.

What they said: "I started getting chemotherapy, but I kept relapsing over and over again before I eventually decided to take on my disease and try to discover a drug that could maybe save my life." -- Fajgenbaum

To enhance patient-centric care, health care must adopt practices from customer-focused industries such as tourism and hospitality, writes Richard Fogel, chief health care outcomes officer for Ascension. These industries excel in understanding customer needs and providing real-time feedback, Fogel writes. "Adopting an approach that is obsessed with understanding and serving our patients and aligns with modern expectations is the only way to transform the health care industry to deepen human connections," he writes.

What happened: Investment in chronic disease prevention is needed to reduce health care costs and disparities, panelists said at AHIP 2025. LaShawn McIver, senior vice president and chief health officer at AHIP and moderator of the session, pointed out that 93% of Medicare spending and 83% of prescription costs are related to chronic diseases. Panelists highlighted the need for collaboration among stakeholders and long-term investments in primary care. 

What's next: Addressing social and economic barriers to care, early detection and evidence-based disease management were among the strategies highlighted by the panelists. Community engagement is also key, as is using emerging technologies and social media to communicate with the public, panelists said. The community should also be involved in benefit design and communication strategies, they said. 

What they said: "If we're not able to address [social] factors, then we're really not able to address the chronic diseases that lead to increased morbidity and mortality of our patients." -- Marisa Rogers, chief medical officer of Oak Street Health

Community engagement is increasingly important in chronic disease prevention and public health, with evolving definitions and models highlighting its role in improving health outcomes. A collection of articles in Preventing Chronic Disease explores various community engagement efforts, emphasizing the need for trust, collaboration and culturally sensitive approaches to address health disparities and promote health equity.

What happened: Transformational change and sustainability in health care will only happen through coordination, collaboration and cooperation, panelists said at AHIP 2025. The conversation also focused on the need for public-private partnerships and the role of technology to improve health care outcomes, affordability and quality. Interoperability and real-time data access are also key, panelists said.

What's next: Data fragmentation must be addressed to promote change, panelists said, and that data must be more accessible and actionable for payers, patients and providers. Establishing transparent and long-lasting partnerships between payers and providers with a patient-first focus will be key, they said.

What they said: "If we look back and we have made a seismic shift in how the consumer takes care of their own care journey, that would be a success." -- Mike Jones, president and general manager of the payer division at Inovalon

Patrick Finn, who leads McKinsey's global health care practice, says the integration of AI and digital technology can disrupt the health care sector by improving data analysis, personalizing care and creating efficient pathways. Finn says resilience is crucial for health care organizations, emphasizing the need for balancing short- and long-term goals, nimbleness and continuous improvement. "How are we improving access, affordability and quality? If you're not balancing those three, you may find yourself in a tough spot at some point -- often sooner rather than later," Finn says.

Here are some thoughts shared by panelists during sessions at AHIP 2025:

"Broadly speaking, instead of putting coverage at risk, we really need the country to tackle affordability, tackle the root causes of high and rising health care costs." -- Mike Tuffin, AHIP president and CEO

"There are really good leaders out there that care about innovation, and there are really good people that care about the patient community and can speak on behalf of them and with them." -- Kathy Giusti, cofounder of the Multiple Myeloma Foundation

"We have a moment. We have an opportunity. If we lean in, we can find a better version of the US health care system." -- Steve Nelson, executive vice president of CVS Health and president of Aetna

"Making a change right now can't be done by one person. But there's a lot of collective power in this room to get together and say, what are the health care priorities of our nation, and how can we get together to establish those in a more meaningful way?" -- Omar Lateef, president and CEO, Rush University System for Health and Rush University Medical Center

"We're all very fortunate because we're in roles that can make a difference. And it's time to show up." -- David Holmberg, president and CEO of Highmark Health