Patient Care’s Next Big Shift: 80% of Leaders Say This Is the Game Changer

Today’s guest post comes from Scott Genone, Chief Product Officer at CareMetx.

Scott shares key findings from CareMetx’s recent survey of over 100 industry leaders. He explains how such advanced technologies as AI and machine learning will reshape patient services and improve the experience for both patients and healthcare providers.

To view the full survey results, download The 2025 Patient Services Report: Provider Engagement is Make or Break for Success.

Read on for Scott’s insights.

Patient Care’s Next Big Shift: 80% of Leaders Say This Is the Game Changer
By Scott Genone, Chief Product Officer, CareMetx

As manufacturers push for smarter, faster tools that enhance patient services, hub partners are under growing pressure to deliver innovative solutions. The 2025 Patient Services Report explores how advanced technologies like AI and machine learning (ML) are revolutionizing benefit verification (BV), improving data accuracy, and driving better patient outcomes.

According to the report, 80% of industry leaders surveyed say digital advancements will soon reshape patient services, with 63% specifically naming AI and ML as the transformative forces that will push hubs beyond outdated models. These technologies are no longer optional for hubs—they are the engine driving a streamlined, efficient experience for both patients and providers.

Transforming Benefit Verification

Electronic medical benefit verification (MedeBV) perfectly showcases how technology is transforming patient services. In the past, manual BV was a time-consuming process involving phone calls, paperwork, and frequent errors, which often delayed patient access to therapy. Today, advanced MedeBV solutions powered by AI and ML automate routine tasks, providing near-instant decisions and enabling hubs to manage larger patient volumes with greater efficiency.

For instance, predictive analytics can use historical payer data to forecast BV outcomes. So, if a particular drug under a specific insurance plan consistently results in a $20 copay without the need for prior authorization, AI-driven systems can recognize this pattern and anticipate similar results for future cases. This accelerates approvals and reduces manual effort. The result? Fewer delays, less stress, and faster access to therapy for patients.

Beyond BV: Building a Connected Ecosystem for Patient Care

Improving individual processes like BV is just one part of the equation. The broader patient services ecosystem—including payers, providers, hubs, specialty pharmacies, and others—requires seamless integration to create a smooth and efficient patient journey. Traditional point-to-point integrations, though, have long been a pain point, adding complexity and driving up costs.

Leading hubs are now addressing this challenge by democratizing data with a gateway-style solution that simplifies connectivity across diverse systems. By using industry standards like FHIR (Fast Healthcare Interoperability Resources), this model enables scalable, plug-and-play integrations that accelerate implementation and reduce complexity. This innovation ensures that every stakeholder—from providers enrolling patients to pharmacies fulfilling prescriptions—has easy access to the critical data needed to support a seamless patient experience.

Provider Struggles Lead to Patient Experience Failures

While improving the patient experience is paramount, leading manufacturers also recognize the critical role of healthcare providers (HCPs) in achieving positive outcomes. The 2025 report reveals that 66% of respondents rank HCP satisfaction as a top business objective, highlighting that a positive provider experience is directly tied to better patient care.

Yet, providers often face significant administrative burdens, with 80% admitting to avoiding certain therapies due to these challenges. To alleviate this, forward-thinking hubs are integrating self-service tools directly into providers' native workflows, such as electronic medical record (EMR) systems. By eliminating the need for branded portals or call-center interactions, hubs reduce administrative complexities, allowing providers to focus more on what matters most—patient care.

Looking Ahead: The Future of Patient Services

The rapid evolution of patient services highlights the critical need for continuous innovation. As manufacturers demand smarter, faster tools, hubs must meet this challenge by harnessing AI, machine learning, and advanced integration technologies. These innovations not only enhance operational efficiency but also elevate the patient and provider experience, ultimately driving improved health outcomes.

To learn more and explore the full survey results, download The 2025 Patient Services Report.

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