Healthcare costs remained elevated this year, making it a major healthcare industry challenge in 2025. Collections remain challenging for medical practices and billing companies as well. In the United States healthcare system, rising costs and workforce shortages continue to squeeze margins and slow reimbursement for healthcare providers across healthcare services. These pressures are top of mind for healthcare leaders and other stakeholders. 

In our recent webinar, healthcare business consultant Aimee Heckman shared strategies from her 35+ years of experience with Tebra's Director of Customer & Partner Marketing, Amanda Zeosky. They walked through the biggest barriers to getting paid and offered practical steps for 2025. 

Watch the full on-demand webinar, or read the highlights below.

These key industry challenges affect how practices and billing companies do business and get paid. Since the pandemic, the healthcare system and wider healthcare industry have faced persistent shortages, recurring supply chain disruptions, and an aging population that raises demand and complexity. 

Across the healthcare sector, organizations are moving toward value-based care, which depends on stronger partnerships among payers, hospitals, and private practices. At the same time, rapid advancements in data, analytics, and virtual tools are reshaping operations and reimbursement. Together, these forces create the context for 2025 planning and day-to-day execution.

Reports show meaningful improvement even as risk remains. In July 2025, US incidents fell month over month, and fewer individuals had their health information exposed. Still, the Change Healthcare cyberattack demonstrated how one event can ripple across healthcare organizations, disrupt claims, and strain clinicians and patients.

To reduce exposure and protect patient safety while improving operational efficiency, focus on the basics and add modern controls:

These steps will not eliminate ransomware or data loss, yet they help practices identify threats sooner and recover faster.

The HIPAA Right of Access requires providers to release records within 30 calendar days. Some states require 15 days. The Office for Civil Rights (OCR), a division of the U.S. Department of Health and Human Services, has continued active enforcement in 2025. In March, the agency imposed a $200,000 civil money penalty against Oregon Health & Science University for failing to provide timely access to records. 

Clear workflows help teams locate and deliver requested health information quickly. Faster access improves patient experience and supports quality care during care transitions. Review request intake, identity verification, and fulfillment steps. 

Train staff. Track deadlines. Document any exceptions. Use patient portals to accept requests and keep audit logs of receipt, status, and completion. These initiatives reduce risk while making compliance repeatable.

Medicare finalized several updates that affect reimbursement in 2025. Per the 2025 Physician Fee Schedule final rule, the Centers for Medicare & Medicaid Services (CMS) confirmed a conversion factor decrease of about 2.83% to $32.35. For primary care, CMS expanded G2211 and introduced advanced primary care management services.

These updates may help practices account for visit complexity and ongoing care coordination. New caregiver training codes also recognize time spent supporting families. These changes touch everyday work for clinicians and shape downstream revenue cycle planning, pricing, and documentation inside electronic health records. 

Some flexibilities continue in telehealth in 2025, though several pandemic-era policies phased down on October 1, 2025.. Practices should review Medicare telehealth policies and place-of-service rules before billing. Together, these updates influence visit scheduling, coding choices, and financial forecasts tied to value-based care.

Payer policies tightened in 2025. Getting paid on the first submission is harder and slower, which strains teams and budgets. These patterns drive denials and rework:

The result is more touches per claim, higher healthcare costs, and pressure on staffing that reduces operational efficiency. Track your top five reasons for denial by payer, CPT, and location. 

Assign an owner. Set weekly targets for first-pass rate and days to payment. Use these findings to prioritize fixes at intake and posting. The next sections outline practical steps to reduce denials and move payments faster with your front desk and coding teams.

Claim denials drain time and cash. Small adjustments help. Use automation and better workflows to optimize eligibility checks, documentation handoffs, and follow-ups. Faster action on clean data keeps care delivery moving. Bills are more accurate on the first pass. Rework falls. 

Patient outcomes improve because visits happen without delays or surprise bills. Set simple targets and measure them weekly. Share results in huddles so teams see progress.

A practice's front desk sets the pace for payment. Tight, repeatable steps prevent errors before they reach payers:

Patient kiosks that sync with electronic health records reduce manual entry and typos. The result is fewer reworked claims, a smoother patient experience, and more high-quality data for healthcare providers at the point of care.

To reduce denials and support smooth audits, tighten documentation and coding at the source by following these best practices:

That consistency helps teams deliver quality care and protects patient outcomes across referrals and settings. Audit a small sample each month, close gaps with quick coaching, and update tip sheets as payer rules change.

Here are 5 items for your 2025 to-do list.

Everyone is working overtime to keep valuable team members and avoid turnover costs. Support work-life balance. Check in often. Ask if roles fit skills. Keep people engaged and invested in the practice's success. Watch for burnout and promote wellness across the healthcare workforce.

Clear, consistent steps present a united front to patients and clients. Walk through processes with staff. Document improvements. Tie updates to specific initiatives and make owners visible to key stakeholders so follow-through happens.

Use technology to reduce routine work and speed payments. Digital intake forms cut errors and start collections before visits. RPA helps billing teams focus on complex tasks. Layer in artificial intelligence, generative AI, and machine learning, where they add real value.

Avoid leaving money on the table. Fill the schedule. Verify benefits at every point of service. Use clear policies on estimates and refunds. Track cost savings and review pricing so adjustments are deliberate.

Measure results and adjust quickly. Build partnerships that expand referral volume or services. Monitor market moves and consider selective mergers that strengthen capabilities and reduce overlap.

Quick tune-ups keep payments moving and problems small. Use this checklist to stay current and confident.

When teams verify data at intake, standardize processes, and use automation, claims move faster, and fewer errors reach payers. That helps providers deliver high-quality care while improving patient outcomes and strengthening operational efficiency.

Aimee Heckman's guidance focuses on what works today: clean documentation, precise coding, and simple front desk routines that keep the revenue cycle moving. Use her tips and track wins.

Want to hear all the nitty-gritty, plus practical examples? Check out the full on-demand webinar.

If you are ready to align scheduling, eligibility, billing, and patient payments in one place, explore Tebra for practical workflows that support cleaner claims and better conversations at check-in.