The first half of 2025 has flown by—and with that, it’s already time for our annual Three-Month Recap. July is always an energizing month for the rule of three® team as we track how the top trends from the March Healthcare Classic are shaping the industry in the months since the tournament wrapped. This year, the competition spotlighted two powerful forces: the surge of technological innovation, led by the rapid adoption of tools like Artificial Intelligence, and the growing influence of policy and politics on the healthcare landscape. The heavyweight trends that earned a spot in the finals are: Make America Healthy Again (2), AI’s Resurgent Debut (1), Medicare Advantage Doubles Down (1), and Access and Capacity (2). Keep reading for our take on the shifts and changes gaining momentum in healthcare’s next chapter.
2025 Champion: Make America Healthy Again (2)
Make America Healthy Again (MAHA) (2)—a newcomer this season—has grabbed industry experts’ and policymakers’ attention in a flurry of conversations surrounding the health of the nation. Likewise, our Selection Committee could not ignore the substantial impact political drivers will have on healthcare in the coming years, ultimately landing MAHA the Championship title.
The MAHA Commission was established by President Trump in February 2025 and is now led by Robert F. Kennedy (RFK) Jr., Secretary of Health and Human Services. The initiative is largely focused on removing additives from food and drink and reexamining pediatric healthcare. The first MAHA report, released in May, outlines several key initiatives. The panel recommends that federal agencies reevaluate pediatric vaccine schedules, ultraprocessed foods, and the effects of pesticides. This is a long-held priority for the Trump administration, with many officials stating that chronic illnesses are rising in American children, stemming from issues such as “poor diet, environmental toxins, unhealthy habits, and pharmaceuticals.”
In May, the Center for Medicare and Medicaid Innovation (CMMI) unveiled its “Make America Healthy Again” strategy to reimagine healthcare delivery and payment models. The framework is built around three pillars: evidence-based prevention, consumer empowerment, and market competition. The initiative aims to improve population health while ensuring fiscal sustainability. CMMI plans to embed preventive services, like screenings and lifestyle interventions, into Medicare, Medicaid, and MA models while increasing patient access to health data and care decision tools. This strategy is already influencing federal priorities and is expected to have far-reaching effects across industries beyond healthcare.
Notably, several provisions in the One Big Beautiful Bill Act align with CMMI’s MAHA vision, such as the $50 billion Rural Health Transformation Fund aimed at supporting struggling hospitals and expanding access in underserved communities. While these investments strengthen the Innovation Center’s push for system-wide reform, they may also introduce new administrative complexities for states and providers navigating overlapping initiatives.
Changes are also being made at the local level, as some states introduce legislation to align with MAHA recommendations. A new bill in Texas proposed warning labels on foods that contain any of 44 identified additives and dyes. In June 2025, Senate Bill 25 was signed into law by Governor Greg Abbott, making it the first law of its kind in the U.S. Research supports that warning labels encourage consumers to make healthier decisions, but it remains to be seen whether this law will be effective in changing consumer purchasing habits.
Similarly, some corporations are making MAHA-friendly changes. Starbucks CEO, Brian Niccol, met with RFK Jr. in June 2025 and shared his intent to modify menus to align with MAHA initiatives. The popular coffee chain is currently testing sugar-free lattes and drinks with up to 15 grams more protein. Further details have not been published, but Niccol confirmed that Starbucks would like to expand into the health and wellness market.
While MAHA has received widespread support, other stakeholders are hesitant. More than 250 groups representing farmers, ranchers, and agrochemical companies have requested to share their input and expertise before MAHA releases any future recommendations. In the Commission’s first report, agricultural stakeholders state there were erroneous claims related to pesticides, and even nonexistent studies that were referenced. These groups argue that pesticides are an essential tool for farmers and help America maintain a competitive farming sector. Agriculture Secretary, Brooke Rollins, has vowed that these groups will be part of the conversation before MAHA releases its next report in August.
Ultimately, MAHA is significantly shaping federal agencies’ agendas and creating ripple effects across sectors like agriculture and food and beverage. Only time will tell if this ambitious strategy can deliver on its promise to improve population health while controlling costs. Keep an eye on our Champion—we expect it to continue driving meaningful change throughout the remainder of the year.
Top Two Trend: AI’s Resurgent Debut (1)
AI’s Resurgent Debut (1) has appeared in various forms over the years, but has never made it to the finals. It’s unsurprising this powerhouse trend secured the runner-up spot this year: adoption of AI is growing fast, with recent studies showing that 65% of hospitals use predictive models.
While AI’s potential in clinical diagnosis and treatment has been widely discussed, this year major advancements have been in front-office operations—helping healthcare systems streamline payer-provider interactions, patient transitions, and administrative tasks. Healthcare organizations are aggressively rolling out AI-powered tools to automate previously manual processes. For example, Allegheny Health implemented AI-driven prior authorization automation to reduce administrative burden and speed up care approvals. Impressively, in the first month of implementation, 70% of requests for CPT codes were approved via the “touchless” system.
Meanwhile, Omega Healthcare, a revenue cycle management company, is using AI-based document processing software to accelerate claims management and payer communications. Supporting over 350 healthcare organizations, including payors and providers, Omega has now automated administrative tasks such as medical billing and insurance claims submission for 60% to 70% of its clients with this new technology.
Cohere Health is similarly advancing AI in payer-provider operations. The company recently raised $90M in Series C funding to expand its AI-powered platform, which streamlines care authorization workflows by analyzing clinical guidelines and leveraging real-time performance data. This approach allows for 90% of requests to be auto-approved, reducing administrative bottlenecks and enabling more consistent decision-making across the care continuum.
On the patient side, companies like Ellipsis Health are developing and scaling AI-enabled care management platforms to support behavioral health monitoring and patient engagement across transitions. In June, Ellipsis secured $45M in Series A funding, backed by major companies like Salesforce and CVS Health. This investment signals strong support from industry players and a promising future for AI in healthcare.
Despite these developments, questions remain about integration challenges, data privacy, and how AI will impact workforce roles. However, the momentum is clear. Health systems and providers embracing AI for operational efficiency are likely setting themselves up for competitive advantage as the technology matures.
The coming year will be crucial in determining how deeply AI transforms healthcare workflows and whether it can deliver on its promise to reduce costs while improving patient experiences.
Top Four Trend: Medicare Advantage Doubles Down (1)
Medicare Advantage (MA) Doubles Down (1) yet again earned a spot in the Top Four. A perennial favorite of the Selection Committee, MA was last year’s runner-up. Yet, despite its staying power, it still hasn’t snagged a championship title. This year was no exception, but who knows? Perhaps 2026 will finally be MA’s year.
Last year, many major insurers rolled back their footprints in the MA marketplace due to rising costs and regulatory pressures. CVS Health, for example, eliminated 10% of its MA plans while Humana, one of the largest MA insurers, scaled back its MA plan benefits and geographic presence. Now, Humana is striking a cautiously optimistic tone. At the insurer’s annual investor meeting in June, many executives doubled down on their defense of MA, citing better care coordination, health outcomes, and savings for older adults—even as critics scrutinize MA for upcoding and inflated government reimbursements. However, financial realities tell a different story: Humana lost approximately 400,000 MA members during open enrollment, and that number is expected to rise by another 150,000 over the year. Anticipating additional headwinds in the MA market, Humana plans to ramp up its Medicaid and primary care businesses to stabilize profits.
The recalibration is not unique to Humana. UnitedHealthcare—the largest MA insurer in the nation—tightened its grip on the market, growing its MA members from 9.5M to 9.9M. While the membership growth is impressive, it comes at a cost. Care usage among UnitedHealthcare’s MA plans was twice as much as projected for quarter one of 2025, slashing profit forecasts by 12%. Yet, the insurer is not retreating from MA. Instead, United plans to improve clinical workflows and use this year’s utilization trends to inform 2026 plan designs and pricing.
Together, these developments reflect a broader reality: the MA market is showing signs of saturation. Compared to 2024, privatized MA plans increased a mere 3.8%, which marks the lowest increase since 2007. As insurers adjust their plans and benefits to maintain profit margins, a few dominant players are emerging in the challenging market.
These tensions occur as the Centers for Medicare & Medicaid Services (CMS) announces a historic 5.1% increase for MA plans in 2026, adding an estimated $25B in additional payments to insurers. This is the largest increase in a decade and a sharp rise from the 2.2% proposed under the previous administration.
While the rate bump delivers a significant financial boost for insurers, some stakeholders have raised concerns about whether CMS’s approach sufficiently balances insurer profitability with the program’s long-term sustainability and oversight.
MA’s performance this year will be critical in determining whether the current trajectory is sustainable or if insurers and policymakers alike will need to rethink their strategies to steer the program forward.
Top Four Trend: Access and Capacity (2)
Access and Capacity (2) received widespread support throughout the tournament from the Selection Committee, landing it a spot in the Top Four. Many industry experts state that these are some of the most pressing issues facing healthcare today, and the Selection Committee agreed.
Access and capacity are multifaceted issues shaped by rising uninsured rates, persistent rural health gaps, and an ongoing shortage of physicians. As of February 2025, nearly half of all rural hospitals are operating in the red, with more than 400 at risk of closure. Rural residents also face stark disparities in terms of provider availability; a 2023 United States Department of Agriculture (USDA) study found there are 5.1 physicians per 10,000 people in rural areas, compared to 8.0 in urban areas. While pandemic-era protections drove uninsured rates down from 2020 through 2023, analysts warn that proposed Medicaid funding reductions could leave approximately 10.9M Americans uninsured in the coming years.
Despite these challenges, many states and hospitals are implementing cutting-edge initiatives to increase access to care. The Massachusetts Department of Transportation has been testing drones to deliver medical supplies directly to residents’ homes. The drones can deliver a 10-pound package up to a mile away. Long-term, the Department hopes the drones can be used for home-based healthcare and emergency medical responses. Similarly, the University of Maryland received a $1.75M grant from the U.S. Department of Transportation to deliver prescriptions via drones to residents on Smith Island and other remote places in the state. After a two-month pause, Amazon relaunched its drone services in March, which deliver prescriptions and over-the-counter medications to customers in Texas and Arizona.
Expanding on high-tech solutions, the University of Michigan is leading a $25M initiative, funded by the Advanced Research Projects Agency for Health, to deploy AI-powered mobile clinics in rural areas like Michigan’s Upper Peninsula. These vans function as fully equipped mini-clinics, using an AI system called VIGIL to guide providers through diagnostics and procedures typically reserved for hospital and clinic settings. By bringing hospital-level services directly to underserved communities, the project aims to reduce reliance on permanent facilities and improve access to care while lowering costs.
Building on this digital momentum, Rush University System for Health recently launched Rush Connect+, a direct-to-consumer telehealth subscription priced at $19 per month. Powered by Fabric’s AI assistant, the service offers 24/7 virtual urgent care and access to human support, expanding Rush’s reach with virtual specialty care across eight specialties. An upcoming app will integrate Epic’s MyChart and AI assistance to streamline patient access and care coordination, further enhancing convenience and connection.
Alongside specialized efforts like the ones above, many hospitals are leveraging new approaches to expand care and improve margins. Telehealth programs, such as Sanford Health’s telestroke network, are enabling life-saving remote diagnosis and treatment in isolated communities. At the same time, Microsoft’s Rural Health Resiliency Program offers AI-powered billing tools like “Claims Co‑Pilot,” which help rural hospitals reduce claim denials that often cost facilities up to $330,000 annually.
These efforts highlight the urgency and the potential payoff of reimagining care delivery—laying the groundwork for a more sustainable and functional healthcare system.
Stay tuned for future posts and insights on the blog as well as LinkedIn.