Navigate Healthcare's AI Future - Beyond the Hype
Discover What's Next in Healthcare Technology
The healthcare payer landscape is shifting faster than ever. Rising costs, regulatory changes, and evolving member expectations mean strategic technology decisions can make or break your competitive position.
The new 2025 Gartner® Hype Cycle™ for U.S. Healthcare Payers delivers an authoritative roadmap to navigate 30+ emerging technologies. This isn't just another technology report — it's your strategic advantage for making informed AI investments that deliver measurable ROI. Through this report, you can:
- Identify which AI technologies are ready for investment versus those in the “hype” phase
- Access clear timelines for technology maturity and adoption
- Leverage industry-specific insights addressing your biggest operational challenges
- See where proven solutions like AI-enabled fraud detection fit your strategic roadmap
Download the 2025 Gartner® Hype Cycle™ for U.S. Healthcare Payers
Join healthcare payer leaders who rely on this strategic intelligence to make confident AI investment decisions and stay ahead of market challenges.
Get Critical Insights for Your Innovation Roadmap
This comprehensive report explores the technologies that will define healthcare payer success over the next decade. Here's what we think you'll discover:
- AI-Enabled Fraud Detection has reached the "Slope of Enlightenment,” which, according to us, means investment is now table stakes and it can deliver immediate impact on your medical loss ratios.
- Payment Integrity Solutions using advanced AI can significantly reduce fraud while improving claims processing accuracy.
- Agentic AI and Autonomous Agents represent transformational opportunities for member service automation and operational efficiency.
- Hyperautomation and Intelligent Prior Authorization offer 2–5-year ROI potential for reducing administrative costs and improving member satisfaction.
Gartner Hype Cycles provide a graphic representation of the maturity and adoption of technologies and applications, and how they are potentially relevant to solving real business problems and exploiting new opportunities.
EXL Recognized as Sample Vendor
EXL is proud to be recognized in this report as a Sample Vendor for AI-Enabled Fraud Detection— In our opinion, validation of our expertise in payment integrity and fraud prevention solutions.
We believe that our AI-powered fraud detection capabilities align with the Gartner recommendations for technologies ready for mainstream adoption. We're helping healthcare payers implement the strategic initiatives outlined in this report.
When you're ready to move from strategy to implementation, EXL delivers proven expertise in:
- Advanced Fraud Detection & Prevention: Identify anomalies, detect fraud, and predict potential payment issues with AI-enabled insights that improve accuracy, reduce false positives, and foster better provider relationships while improving medical loss ratios.
- Root Cause Analysis & Process Optimization: Uncover and systematically address errors and problematic billing patterns earlier in the claims lifecycle, shifting focus from managing symptoms to addressing root causes.
- Automated Claims Processing & Cost Reduction: Automate claims processing with significantly less administrative effort while contributing to cost savings by reducing operational expenses and optimizing recovery.
Gartner, Hype Cycle for U.S. Healthcare Payers, 2025, By Robert Potts, Connie Salgy, Austynn Eubank, 16 June 2025
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