This blog is co-authored by Verinovum experts David May, Maiuri Ranchhod, MD, An-Chan Phung, Mureen Allen, MD, FACP, and Mike Noshay, MSE.
Each year, the Verinovum team makes predictions about what the new year will bring for healthcare, and 2022 proved to be another eventful year.
COVID-19 cases spiked at the start of 2022 but have mostly leveled off. Meanwhile, viruses like monkeypox, RSV, and influenza threaten to eclipse the coronavirus, which is now years on from its initial arrival on the global stage. In-person conferences are once again a thing, hospitals are limping toward financial calamity, health plan value is more scrutinized than ever, and some of the biggest names in consumer retail are making huge inroads into healthcare delivery.
So, how’d we do in our New Truths of 2022 predictions? Not half bad, even if many of our forecasts are difficult to measure due to the lagging nature of many healthcare metrics.
Telemedicine continues to grow: Prediction grade: B
Our prediction that telemedicine would continue to climb in popularity appears to have been prescient. Telehealth utilization, as a percentage of all medical claim lines, was essentially unchanged from August to September at 5.4%, according to Fair Health, but that’s up from 4.4% from September 2021. Despite limited growth, industry leaders are still advocating for its adoption. Writing in Harvard Business Review, Robert Pearl of Stanford Medicine and Brian Wayling, executive director of telehealth services at Intermountain Healthcare, outline five advantages of using telehealth that they contend would reduce healthcare spending by 15-20%, among other benefits. “Any nation seeking to raise health care quality, increase access, and lower costs should be expanding, not contracting, the use of virtual care.”
Cyberattacks rise: Prediction grade: A (unfortunately)
Sometimes we wish we were wrong. The Department of Health and Human Services (HHS) reported that healthcare data breaches involving at least 500 victims totaled 244 during the first five months of the year, a nearly 44% increase from the same period in 2021. In the third quarter, healthcare was the most-targeted industry for cyberattacks, with one in 42 organizations affected by ransomware, a year-over-year increase of 5%, per Check Point Research. Unfortunately, the vulnerabilities exposed by the pandemic, coupled with the sheer amount of valuable personal information found in healthcare data, make the industry an attractive target for hackers. In fact, healthcare has now had the most expensive data breach costs of any industry for 12 years running.
Fraud, waste, and abuse climb: Prediction grade: B+
This one is difficult to judge, given the lagging administrative data, but there is little doubt that healthcare fraud remains a big problem. In a report to Congress, the HHS Office of Inspector General highlighted “nearly $3 billion” in recoveries expected from audits and investigations, with 320 criminal enforcement actions and 320 civil actions spanning six months ending March 31, 2022. Estimates put fraud between 3% and 10% of total healthcare spending, with costs as high as $410 billion, based on 2020 national health expenditure data. Fraud common practices include double-billing, un-bundling services, or using another person’s insurance to pay for services.
Efforts to improve unstructured data increase: Prediction grade: A
As we wrote, there is a huge need to make sense of all the data in a patient’s chart — especially unstructured clinician notes, which require manual capture, abstracting, and reporting, making it ripe for errors. So far, the healthcare industry seems to be turning to natural language processing for help interpreting unstructured data. One report forecasts the global market for the technology in healthcare and life sciences to grow to $7.2 billion by 2027. Still, we believe fixing unstructured data is the prudent course. In its 2022 State of AI, Appen notes that “51% of our survey participants agree that data accuracy is critical to their AI use case and 46% agree it’s important but can work around it. Only 20%, however, reported achieving higher than 80% data accuracy and only 6% reported higher than 90%.”
Chronic disease diagnoses increase: Prediction grade: A
The outlook isn’t good even though the data isn’t in yet for chronic disease diagnoses. The aging population, coupled with the effect of the pandemic in postponing doctor visits, seem to point toward a crisis of chronic disease. The pandemic infamously fueled a large increase in the U.S. mortality rate and a big drop in life expectancy in 2020. Death rates also rose that year for six of the 10 leading causes of death, including diabetes and heart disease, reversing a decades-long decline. Having high-quality data available to identify those who have missed care, are at risk, and need to undergo a screening will be critical for early intervention and reversing the trend.
Value-based care models expand: Prediction grade: B
While full-year data will help paint a better picture, growth in value-based care appears to have been modest in 2022. The number of accountable care organizations participating in the Medicare Shared Savings Program inched up to 483 this year, from 477 in 2021. A March report from McKinsey & Co. found that value-based plans are expected to grow to cover 22% of insured lives by 2025 from 15% in 2021, meaning an extra 65 million Americans. The pandemic appears to have slowed growth, while physicians also cite limited finances, staffing constraints, and the need for effective coding and billing processes as barriers to entry.
FHIR adoption and patient data access expand: Prediction grade: A
The Fast Healthcare Interoperability Resource (FHIR), a data standard for exchanging disparate sources of healthcare information, promises great things for patients’ ability to finally receive and review their own data. Lo and behold, Oct. 6 was patient data liberation day, when healthcare organizations had to be ready to hand over care records to patients in a digital format without delay. It’s too soon to tell how useful patients will find these early attempts to digitize and clean up years of disparate clinical records, but we’re not overly optimistic.
CMS pushes data interoperability: Prediction grade: B+
The year was bookended by two major pieces of CMS interoperability regulations. In January, the ONC kicked off the year with the publication of the Trusted Exchange Framework, Common Agreement, which establishes the infrastructure model and governing approach for users in different networks to securely share basic clinical information. In December, CMS posted the Advancing Interoperability and Improving Prior Authorization Processes Proposed Rule in the Federal Register to further support data exchange and interoperability. Momentum is building for this prediction to come to fruition.
Increasing role of intelligent devices and IoT in creating personal health records: Prediction grade: C
The rising popularity of wearable technologies like smartwatches, monitors and Fitbits holds great promise for things like remote patient monitoring, collecting vital signs, diagnosing, and early detection of risks. The global IoT healthcare market was estimated at $99.6 billion in 2022 and projected to swell to $486.3 billion by 2031. Unfortunately, there is scant evidence that providers have learned how to start using the reams of health data these devices produce in directing patient care. We may have jumped the gun on this one.
Emphasis on SDoH and health equity grows: Prediction grade: A
Analyzing the Census Bureau’s Pulse Survey data from March about the lingering effects of the pandemic, the Kaiser Family Foundation found widespread ongoing hardships for black and Hispanic people and younger adults. The pandemic sparked federal funding and a variety of innovative state-level programs targeting health disparities and social determinants of health. It’s clear more permanent strategies are needed to promote health equity.
The new year promises yet more twists and turns. Stay tuned for our 2023 New Truths, coming to the Verinovum blog soon!