Scrolling Through the Roadmap of 2022 Healthcare Trends, With Sixteen Selected Stops

By Clive Riddle, January 6, 2022

2022 will offer a complex, challenge-filled healthcare landscape, that can’t be navigated with a roadmap viewable on a device screen without a whole lot of scrolling involved. So get ready to slide your finger or mouse downward a few times to bring these sixteen selected healthcare trends for 2022 into view.

Pandemic Permanency – The healthcare industry and the general public will continue to evolve through a similar process to the stages of grief – starting with denial and ending with acceptance – that COVID-19 will not go away in 2022, even though it may become more manageable in daily life and variants may become milder. A spectrum of measures and behaviors that initiated during the past two years may further modify with time, but will not fully disappear in 2022, or beyond for that matter.  

Advancing Health Equity – health equity awareness and programs launched during the pandemic to fund equity initiatives and create positions to manage these activities, will gain significant momentum in 2022, including increased deployment of analytics to identify specific healthcare inequities and driving factors behind them.

Increased Utilization - Deferred care during the pandemic due to reduced availability of non-COVID related services, as well as deferral due to cost considerations and economic hardship will now impact 2022 as deferred care gets addressed. While utilization increased in 2021 compared to 2020, the spike will be more material in 2022 as some care continued to be deferred in 2021.

Healthcare Pricing Inflation – Provider financial losses and cost increases experienced during the pandemic will drive greater provider price inflation, which along with increased utilization that will drive greater health plan premium inflation during 2022.

Employer and Public Payer Pushback on Price Increases – Employers and government are facing their own significant pandemic-driven cost and funding pressures, and are in no position to easily absorb material provider and payer price increases. There will be a range of responses, including renewed interest in greater employee cost sharing, greater degrees of bidding and changes in plans, benefits and provider networks, and CMS measures to reduce overall payment to providers and plans.

Stepped-Up No Surprises and Price Transparency Enforcement: There are already material numbers of providers and payers seeming to not be in compliance with the new regulations. Patient, employer and public payer pushback on price increases and unhappiness with levels of patient out-of-pocket costs will drive political demand for much greater and highly visible enforcement of compliance issues with No Surprises Act and Pricing Transparency requirements.

Increased Payer-Provider Contracting Tensions – The always fraught-environment between payers and providers will become even more frayed, as pricing inflation and cost pressures mount in the midst of employer and public payer pushback. Even with value-based payer-provider collaborations designed to mitigate such rifts, high-stakes contract negotiations and terminations will become more prevalent.

Increased level of risk assumption in value-based agreements – The one safety valve in a higher pressure payer-provider environment will be greater assumption of risk, a direction that an increased portion of providers have been gravitating towards during the past several years. The shift will continue and accelerate during 2022.

Reduced SDoH investments due to cost pressures – While compelling cases can be made on the ROI for funding appropriate Social Determinants of Health initiatives, payer and provider cost pressures will drive budget cuts, and items involving more indirect and longer-term return on investment are more vulnerable. However, as health equity is more in the spotlight for 2022, SDoH activities that are the most directly linked to improving health equity may have relatively better odds of retaining or obtaining funding.

Network coverage issues with remote workforce – As remote work in various sectors of the economy continues to gain a greater permanent foothold - beyond the pandemic period – employers and payers relying on narrower network coverage will have to develop permanent solutions.  A menu of approaches will be more widely deployed, including use of out-of-area telehealth services before authorizing in-person services out-of-area, and greater use of sub-contracted national networks or companion products.

Continued Medicaid and ACA Marketplace growth – Medicaid enrollment will only continue to grow in 2022, as additional states implement ACA Medicaid expansion, and ACA Marketplace enrollment for 2022 appears strong due to a variety of factors. Of course, 2023 may be a different story, if the anticipated mid-term election shift to Republican-controlled both houses of Congress occurs, and their sentiment is strong to revisit further ACA rollbacks or repeal.

Provider Workforce Erosion – Beyond the general pandemic driven labor shortages throughout the economy, healthcare will experience a greater workforce erosion in 2022 as physician, nurse and other clinician burnout due to the pandemic and other factors accelerates, combined with the chilling effect on potential new workforce entrants, impacting staffing shortages and productivity. On top of this, provider cost pressures and consolidations will spur layoffs in some markets, with some clinicians choosing to early retirement or switch careers as a result.

Continued adoption and advances in AI: Announcements on healthcare artificial intelligence technology offerings and adoption abound with a dizzying array of applications. If 2021 wasn’t already anointed the year of healthcare AI, 2022 might be crowned as such.

Increased Payer and Provider Stake in Tech Ventures – Strategic investment from health plans and health systems will further proliferate in a spectrum of healthcare tech platforms - not to mention startup ventures or acquisitions solely owned by a provider or plan. The term payvider has grown into greater use describing payers that have acquired or launched significant provider offerings, and vice-versa, What do we call the increasing number of three-headed players wearing provider, payer and tech-platform hats?

Continued high level of M&A – Looking beyond tech ventures, payer and provider M&A transactions involving other payers and providers will certainly not diminish in 2022, as stronger providers acquire those weakened by the pandemic, and larger payers seek continued growth through acquisition in Medicaid and Medicare Advantage markets. A number of venture backed plans, many with tech platforms, will have a particular need to seek growth through acquisition of smaller plans, or seek to be acquired themselves.

No major healthcare legislation – With mid-term election occurring in the fall and little potential for bipartisan action existing previously, the political appetite for tackling health policy legislation would seem to be quite suppressed for 2022.

That’s all folks! This may just be scratching the surface, but it is the end of road for now. Best wishes to all navigating healthcare through 2022!