Mansoor Khan , 2025-04-14 14:19:00
As we navigate through 2025, the American healthcare system stands at a critical juncture. The demographic shifts that have been gradually unfolding are now accelerating, creating challenges that will fundamentally reshape how care is delivered over the next decade. Having worked with healthcare organizations across the country, I’ve observed firsthand how these changes are already impacting care delivery, and I believe we must prepare now for the transformed landscape that awaits us in 2035.
The demographic imperative
The most significant driver of change in healthcare isn’t a new technology or government policy — it’s demographics. In 2015, our society supported approximately four workers for every retired person. By 2035, that ratio will shrink dramatically to just two workers per retiree. This fundamental shift creates more challenges that will affect every aspect of our healthcare system.
This demographic pressure is already manifesting in staffing shortages. As of 2025, we’re experiencing approximately a 5% shortage of physicians nationwide. By 2035, projections suggest this shortage will double to 10%, meaning we’ll have only 90% of the physicians needed to support our aging population. Consider that securing an appointment with your physician today often requires weeks or months of waiting — now imagine this situation when the elderly population requiring care essentially doubles.
Financial sustainability under pressure
The demographic shift places enormous strain on our healthcare financing systems. The federal government already allocates trillions to healthcare spending, primarily through Medicare and Medicaid. As the ratio of contributors to beneficiaries’ changes, maintaining the quality-of-care Americans expect will require significant innovation in both funding mechanisms and care delivery models.
Simultaneously, healthcare consumers are becoming increasingly sophisticated. Patients arrive armed with information gathered online and expect a consumer experience comparable to what they receive in other sectors. This rising consumerism creates additional pressure on healthcare organizations to deliver not just quality clinical outcomes but also exceptional service experiences.
Value-based care: The path forward
To address these converging challenges, value-based care has emerged as the dominant strategy, and I believe its momentum will continue regardless of political shifts. What does this mean in practical terms? We can expect:
- Increased capitation models that align provider incentives with population health outcomes
- A significant expansion of home-based care delivery
- Greater emphasis on primary care to manage health proactively
- More direct payer involvement in care delivery as they acquire practices and provider organizations
This transition from costly hospital-centric care to more distributed, prevention-focused models represents both a necessary evolution and a profound opportunity to reimagine healthcare delivery.
Technology as the essential enabler
None of these transformations can succeed without technology serving as the foundation. Three technological capabilities will prove particularly crucial:
1. Enabling top-of-license practice – We must deploy technology that allows every healthcare professional to practice at the highest level of their training and licensure. Primary care physicians shouldn’t perform tasks that nurses could handle, and nurses shouldn’t be occupied with work that care managers could accomplish. Technology must help us allocate our limited human resources optimally.
2. Expanding care venues – As care increasingly shifts to homes and virtual settings, technology must support seamless care delivery across these expanded venues. Initiatives to remove state-by-state licensing barriers for virtual care will accelerate this trend, allowing providers to reach patients wherever they are, when they need care, in the most cost-effective manner.
3. Making data actionable – Healthcare may generate more data than any other sector of our economy, but much of it remains trapped in silos. Even when data becomes accessible, it often isn’t actionable. Technology must evolve to not just integrate data but to transform it into actionable insights that fit seamlessly into clinical workflows.
Navigating policy uncertainty
While the demographic and technological forces shaping healthcare are clear, policy environments can shift. The current administration will likely maintain stability in Medicare Advantage while potentially reducing ACA subsidies but also relaxing plan requirements. Medicaid faces the greatest uncertainty, with proposals to reduce federal expenses and shift more responsibility to states.
Despite these policy fluctuations, the fundamental challenges of demographics, workforce shortages, and financing constraints will persist. Organizations that embrace value-based care models and leverage technology to expand access while controlling costs will be best positioned to thrive.
Conclusion
As we look toward 2035, the healthcare organizations most likely to succeed will be those that:
- Embrace technology that makes data actionable and integrates seamlessly into workflows
- Develop care models that extend beyond traditional settings into homes and virtual environments
- Focus on preventative care and population health management
- Create consumer-friendly experiences that meet rising patient expectations
- Build financial models sustainable under value-based care arrangements
The decade ahead will test our healthcare system like never before. But within these challenges lies an opportunity to create a more accessible, effective, and sustainable healthcare system — if we dare to innovate and adapt to the changing landscape.
The demographic realities cannot be avoided, but with thoughtful application of technology and reimagined care models, we can build a healthcare system ready to meet the needs of all Americans in 2035 and beyond.
Photo: rudall30, Getty Images
Dr. Mansoor Khan is the Chief Executive Officer of Persivia. Inc. Dr. Mansoor Khan is a 20-year veteran of the software and healthcare industries. He is a serial entrepreneur who has been developing advanced technologies and cutting-edge software since the mid-90s. Over the years, he has led teams that have developed technology and applications for Disease Surveillance, Artificial Intelligence, Quality Management, Analytics, Care Management and Cost and Utilization Management. These efforts have won numerous awards over the years including best Decision Support System for ACOs (Blackbook) and Top 100 AI companies.
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