September 2025 | By Softheon
Key takeaways from the Strategy in Action 2025 Survey:
- This yearly survey found 70% of healthcare executives expect major industry disruption within two to five years, yet only 2% feel very ready to meet the challenges.
- Growth is a priority, and half of organizations are looking beyond traditional revenue streams to diversify (e.g., ICHRA, other options) in the uncertain market.
- Infrastructure to support innovation is lacking — only 29% say their company’s processes meet current needs, and just 7% believe they are future-ready.
- The expected turbulence means health plans must build innovation into daily operations to manage disruption and seize opportunities.
Healthcare executives see the storm coming — but most don’t feel prepared to weather it. The Strategy in Action 2025 survey of healthcare leaders reveals how they are navigating rapid change and where preparedness falls short.
This report is the only known source repeatedly capturing how over 40 executive healthcare leaders nationwide are currently approaching strategy, innovation, and planning. Spring Street Exchange, a consulting firm for health plans and providers, conducted the survey with support from Softheon and Milliman. Respondents were healthcare executives, 60% of whom represented payers. The report’s insights help industry executives benchmark against peers and plan for the future.
According to the findings, healthcare organizations report being more strategic, proactive, and forward-looking, but the data suggests that perception doesn’t quite match reality. Surveyed executives acknowledge significant gaps in strategic clarity, infrastructure, and adaptability. To close those gaps, they must build an infrastructure that supports innovation alongside daily operations.
Let’s examine the findings and the takeaways for health plans.
1. Healthcare Disruption Is Here
Seven in 10 industry leaders expect major change over the next two to five years, up 40 points from last year.
“Five years ago, the answer to this question would have been 1%. When we saw 30% in 2024, we thought: Wow. To see that spike to 70% one year later is dramatic for an industry unaccustomed to such rapid shifts,” said Nancy Wise, president of Spring Street Exchange.
What’s driving the disruption? Survey respondents expect the following market dynamics to have a moderate or major impact on their organization:
- Political and regulatory uncertainty (100%)
- Emerging tech (96%)
- Aggressive competition (75%)
Other factors included M&As, shifting social norms, population shifts, and environmental risks.
Health plan takeaway: Health plans should treat disruption as inevitable and expand their market strategy through strategies like designing new individual products, creating supplemental benefits, or testing alternative coverage models.
2. Growth Tops Long-Term Priorities
Most survey respondents reported growth as critically or very important to their long-term plans.
Organizations are pursuing growth through:
- Existing market expansion (80%)
- Non-traditional revenue streams (51%)
- Expanding geography (47%)
- Launching a new product/service (43%)
Interest in new revenue streams has increased sharply year over year. Spring Street Exchange views this change as an encouraging sign of industry optimism and resilience.
Health plan takeaway: Don’t rely too heavily on existing markets, as this may limit resilience if things change faster — or differently — than anticipated. Diversifying into new products, services, or geographies can help balance risk.
3. ICHRA Presents an Opportunity for a New Revenue Stream
Individual Coverage Health Reimbursement Arrangements (ICHRA) is a promising new revenue channel. Spring Street Exchange found that roughly half of the payers surveyed are considering, developing, or offering ICHRA. Few payers answered the question about their preparedness to execute on ICHRA opportunities — which could indicate untapped growth potential for plans willing to invest early in ICHRA capabilities.
“With the legislative changes we’re all watching, it’s clear that relying on the same markets won’t work. These shifts make new lines of business, like ICHRA, more attractive. By diversifying now, plans can drive market growth amid volatility and extreme uncertainty, ” Softheon Health Plan Solutions Director Lindsey Miller explained in a webinar discussing the findings.
Health plan takeaway: ICHRA offers payers a way to diversify revenue sources and expand their membership market.
4. Confidence Outpaces Readiness
The healthcare industry is notorious for slow, incremental change, and organizations have built their business models to operate at this pace. As a result, the sector is likely under-equipped to manage the velocity and magnitude of the impending disruption, and survey respondents confirmed this point of view with their responses:
- 2% felt very prepared to handle market changes
- 60% felt moderately prepared
- 38% felt slightly prepared
Based on its in-depth analysis, Spring Street Exchange suggests some “moderately prepared” organizations may be overestimating their readiness. Most of those surveyed have not built the infrastructure to support novel changes. Three-quarters reported having limited or no formal structures or processes to support innovation or the use of emerging technologies. Only 29% said their infrastructure meets current needs, while just 7% believed it will meet future demands.
Limitations mentioned include:
- Innovation committees that rarely meet or are deprioritized due to competing urgent priorities.
- Innovation functions that focus on vendor evaluation rather than proactive innovation to support strategic goals.
- Prioritization of opportunities driven by passion or instinct of specific individuals vs. a consistent way to explore ideas and test market impact.
- Focusing on ideas that are new to the organization but not new or innovative to the market.
When it comes to technology, almost two-thirds of respondents believe AI, automation, and analytics will disrupt traditional business models. However, only 16% describe their organizations as proactively leveraging these tools.
Most AI initiatives are concentrated in pilot or exploratory stages for tasks like decision support, operational efficiency, and individual productivity. Advanced applications remain rare, but the research suggests growing interest and experimentation.
“AI enables more than efficiency. Advanced applications give health plans new ways to think about industry problems and opportunities. That’s how they can stay agile as disruptions shift the market. Investing in AI education and adoption will help turn opportunities into tangible growth,” said Miller.
Organizations report struggling against barriers like competing priorities, budget constraints, and time limitations. These challenges will not disappear.
“Too many organizations have the mindset that innovation must wait for stability or some perfect moment. There is no such thing. The most powerful breakthroughs and advancements often emerge under challenging — rather than ideal — circumstances,” said Wise. “Surviving the coming change will require an innovation infrastructure to exist in parallel with ongoing operations.”
Health plan takeaway: Don’t wait for things to settle down. Payers that embed innovation and technology adoption as a core function can view disruption as an opportunity, not a crisis.
How Can Health Plans Manage Uncertainty?
Spring Street Exchange advises against “hunkering down.” Instead, use disruption as an entry point to reallocate, refocus, or pivot. A curiosity mentality empowers you to find and take advantage of market gaps.
Long-term success requires infrastructure. Without formal processes — such as tracking mechanisms or cross-functional accountability — even strong strategic ideas risk stalling. These steps will enhance your innovation capabilities:
- Create a cross-functional innovation leadership group.
- Build a phased process for evaluating and testing ideas that optimizes resources.
- Target areas for innovation that fulfill the strategy and lead to differentiation.
- Establish criteria to evaluate new concepts against standard processes.
- Initiate a feedback loop and learning mechanism that permits risk and enables organizational learning from unsuccessful initiatives.
With this framework in place, you can reimagine product offerings, revenue streams, and business models while still managing immediate business needs.
Innovation includes advanced applications of AI. Beyond streamlining processes, AI enables strategic creativity, supporting you in reinventing healthcare delivery, administration, and management.
These are just a few of the potential use cases for AI technologies:
- Support clinical, financial, and strategic decisions
- Identify unmet member needs
- Enable data-driven product development and new revenue stream creation
- Improve member experience through automation and personalization
- Accelerate idea testing, prototyping, and innovation
- Model multiple future scenarios, including regulatory and market changes
Consider this example. In testimony before Congress, Alignment Health CEO Dawn Maroney detailed how the health plan uses AI to identify its sickest members. This insight allows Alignment Health to deliver home-based, personalized care that often prevents costly interventions. The result of this initiative: Better health outcomes, stronger member relationships, and reduced costs.
How Can Plans Turn Healthcare Disruption Into Opportunity?
Unprecedented change is coming fast, but it doesn’t have to cause setbacks. Disruption creates space for reinvention. Abandon the urge to wait for the perfect moment and embed innovation initiatives into your everyday operations now.
Softheon reduces the chaos of change by taking on complex pieces of health insurance like shopping, quoting, enrollment, billing, and communication via expertise, automation, AI, and infrastructure. Our end-to-end platform brings enrollment, billing, payments, and member management into a single ecosystem, so you can focus on advancing your core mission while supporting new revenue channels like ICHRA.
Contact us to learn how Softheon can help you prepare for the changes ahead.
Survey methodology
Spring Street Exchange developed the 40-question survey with support from Softheon and Milliman. Conducted from February to April, it received 49 unique responses from healthcare executives across 22 states. Participants were primarily from payer or provider settings, with a significant portion being C-suite executives. This is the third year for this survey.
