2021 has been yet another strange year in healthcare and beyond. We saw the widespread distribution of life-saving vaccines, the return of healthcare conferences (albeit often virtual), and the adoption of new technologies including FHIR. Throughout the year, several new–and sometimes harsh–truths emerged.

A year ago, the Verinovum team and I took out the proverbial crystal ball to try to predict the new truths of 2021 in a Healthcare IT Today article (read the full article here). I’m proud to say we did pretty well. Here are some of the highlights:

Medicaid enrollment: We predicted that Medicaid populations would rise, and this proved to be true throughout the year. As we all know, many Americans lost their jobs during the early days of the pandemic. That means, of course, that many lost their employer-sponsored health insurance, which caused an influx of Medicaid enrollments. Data from the Kaiser Family Foundation¹ shows that Medicaid/CHIP enrollment is increasing to the tune of a 14.7% increase between February 2020 and March 2021. Throughout that period, every state experienced Medicaid/CHIP enrollment growth ranging from 9.3% to 29.2%. Prior to the pandemic, (March 2019 until March 2020), there was an aggregate enrollment decline of 1.3%.

Vaccination rates: We predicted that the number of Americans willing to be vaccinated against COVID would be less than 50%. I’m not usually proud to be wrong, but in this case, I’m happy to report that our guess proved to be a bit low. As of the writing of this blog post, the current vaccination rate nationwide did exceed that prediction–we’re currently at 61%. Unfortunately, it wasn’t easy. It wasn’t until July 19, 2021 that we hit the 50% mark², and in some areas of the country, aggressive campaigns and incentives were necessary to encourage people to get vaccinated.

Star Ratings for Medicare Advantage (MA) plans: We predicted that increasing quality demands and the uncertainty of the healthcare landscape would cause many MA plans to experience a decline in Star Ratings. In fact, this year’s ratings did show significantly fewer MA-Prescription Drug enrollees in contracts with 4.5 stars. Data released by CMS showed that “approximately 19.6% of enrollees are in contracts with 4.5 stars, equating to an 11.8 percentage point decrease as compared to the share based on the 2020 Star Ratings. Furthermore, enrollment in 4-star rated contracts is 7.9 percentage points lower, while enrollment in 3.5-star-rated contracts is 17.9 percentage points higher, going from 15.8% in 2020 to 33.7% in 2021.”³

An influx of childhood diseases: We predicted that healthcare would see a surge, or resurgence, in pediatric illnesses. Unfortunately, this prediction came to fruition. According to the World Health Organization (WHO), the pandemic disrupted the supply chain for life-saving pediatric vaccines globally. Lack of transportation, economic hardships, and pandemic restrictions all contributed to missed routine childhood vaccinations. A New York Times article⁴ reported that approximately 23 million children missed out on routine vaccinations last year–the highest number in more than a decade. The result has been measles, polio, and other preventable disease outbreaks. This could pose additional risks in the future as many countries ease COVID restrictions, exposing children who are now more vulnerable to infectious pathogens.

Beyond pediatrics: It’s not just unvaccinated children who are experiencing negative effects from the pandemic. In our predictions, we anticipated an increase in chronic disease diagnoses. The pandemic has led many people to forego testing, follow-up, and treatment for chronic conditions. According to a CDC report in June, it is true that those with chronic conditions are profoundly impacted from COVID. “Heart disease, diabetes cancer, chronic obstructive pulmonary disease, chronic kidney disease, and obesity are all conditions that increase the risk for severe illness from COVID-19.”⁵

The final interoperability rule: Lastly, being a team of data quality advocates, our team speculated that the final interoperability rule would shine a light on the data quality issues across the country. The final interoperability rule requires payers to initially make data accessible to patients and then to other payers. Throughout this year, we’ve seen several articles published about the effect poor quality data has had on patient outcomes. Regardless of who is transmitting data, medical record companies have been sued for using flawed data in their algorithms. We’re learning time and time again that the best technologies will still fall flat if the quality of the data we use isn’t good enough. From collection to retention and analysis, clean and accurate data can make a significant impact on business outcomes and health outcomes.

All in all, we did pretty well in predicting healthcare’s new truths for 2021. What does 2022 have in store? Check back soon for our 2022 predictions!

¹ https://www.kff.org/coronavirus-covid-19/issue-brief/analysis-of-recent-national-trends-in-medicaid-and-chip-enrollment/#:~:text=Data%20show%20that%20Medicaid%2FCHIP,by%2011.5%20million%20

or%2016.2%25.&text=Over%20this%20period%2C%20all%20states,32.2%25%20(Figure%202).

² https://ourworldindata.org/covid-vaccinations?country=USA

³ https://avalere.com/insights/fewer-highly-rated-ma-plans-in-2021-than-in-2020

⁴ https://www.nytimes.com/2021/07/15/world/million-children-vaccinations.html

⁵ https://healthitanalytics.com/news/chronic-lung-disease-causes-severe-covid-19-infections