Top healthcare trends 2022

Drivers, opportunities, and risks are shaping financial services.

Covid-19 exacerbated chronic challenges within the global healthcare industry. It became a catalyst amid fierce competition and tight regulations for health providers and payers to focus on digital health, cyber-security, patient data transparency, and a variety of customer-centric and operational enhancements. As a result, Capgemini found the 2022 trendline pointing to improvements in access and quality of care.

Healthcare challenges, such as optimizing the cost of care while simultaneously enabling personalized interventions and consumer-friendly shoppable services are long-standing – but, historically, the industry has been slow to react.

This article examines the lingering ramifications of the pandemic, heightened patient-focus, and the worldwide impact of ever-changing regulatory environment.

When quantifiably transforming clinical experience and outcomes, technology, such as AI-powered predictive analytics and machine learning is pivotal. However, providers and payers face numerous decisions about which solutions and HealthTech partners can best help to resolve their technology debt while enabling agility, innovation, and relevance in the years to come.

Not surprisingly, a wave of industry consolidations is cresting as mergers and acquisitions enable horizontal and vertical integrations between ecosystem players that support cost efficiencies and extend patient care.

As virtual delivery of healthcare services becomes increasingly urgent, value-chain participants are coming together to build the modern infrastructure necessary for effective patient engagement. Access to real-time patient data is driving better health outcomes and efficient medical management. Today’s imperative is to prioritize whole-patient healthcare through preventive care solutions.

The shift to virtual healthcare delivery and seamless, coordinated care requires data interoperability and migration to the cloud. Therefore, healthcare providers and insurers are exploring ways to manage, store, and leverage the enormous patient data they generate – cost-effectively.

While digitization is a critical enabler, it also raises potential cyber-attack vulnerability. Therefore, robust security strategies are high on the agenda for 2022 to protect sensitive patient data and avoid organizational losses.

Strategic collaboration with hyperscalers, HealthTechs, and non-traditional players can help industry leaders agilely incorporate requisite new capabilities and operational efficiencies.

Leading healthcare ecosystem players are preparing for imminent and full-scale industry transformation. They understand that agile and strategic responses to global dynamics and patient expectations will directly affect patient-focused care delivery and consistently positive health outcomes.

Covid-19 fast-tracked digital health for a seamless patient experience across care journeys
As the industry reimagines post-pandemic business practices, providers and payers are adopting a digital-first approach to integrate healthcare experiences.

Context. The pandemic fueled an urgent need to implement digital health practices – virtual care, telehealth, telemedicine, remote patient monitoring, and omnichannel-enabled member care. It exposed cracks in the healthcare system globally, and the industry now faces a massive provider shortage. The situation was exacerbated by the lack of coordination as patients passed through various stages of care, from acute to chronic and vice versa.

Catalysts. Healthcare delivery turned to remote/virtual alternatives as hospitals, clinics, and practices reduced non-emergency visits because of contagion fears, lockdowns, and social distancing. Covid-19 prioritized digital transformation for healthcare establishments to enable safety, next-generation care, and outcomes. Investors funded the digital health industry with a record USD 21.6 billion in 2020, according to market and consumer data specialist Statista. The global digital therapeutic consumer base was projected to grow to 44 million users by 2021 – a 288-percent increase from pre-pandemic levels. Digital therapeutics are technology-driven, evidence-based interventions to prevent, manage, or treat a medical disorder or disease.

In a nutshell. Healthcare players are expanding digital health by offering a combination of digital and physical care delivery models. This shift is increasing among providers and payers, and the sector has become a hotbed for investors and startups. United Healthcare partnered with telehealth provider Amwell to provide a platform for virtual care and clinical services with low or no copay for routine care. The program kicked off in early 2021 for employers in 11 US states, including Colorado, Texas, and Maryland, as well as the District of Columbia.

Swiss telemedicine specialist Medi24, an Allianz Partners subsidiary, launched a symptom triage tool that deploys a conversational AI chat function, featuring a unique character-based interface designed by San Francisco HealthTech Sensely.

Singapore telehealth startup Doctor Anywhere launched an online mental health video consultation service that allows users to choose from a panel of registered psychologists and counselors and book therapy sessions over video consultation on the Doctor Anywhere app.

Impact. Virtual primary care gives patients the power of choice and convenience and provides the flexibility needed for better health outcomes. Digital health offers patients and health insurance members better access to healthcare professionals. A significant percentage of likely inpatient admissions has shifted to outpatient or virtual care settings in the post-pandemic era.

Digital tools give providers a more holistic, data-driven view of patient health, enabling personalized engagement and superior member experience.

Patient-centric, personalized care, and a shoppable experience will significantly enhance patient engagement
Context. The double whammy of a shifting population mix, and unprecedented consumer acceptance and desire for digital engagement during the pandemic. boosted demand for Amazon-like experiences in the healthcare sector.

Catalysts. Heightened participation of patients in their healthcare journeys is driving the personalization of care interventions and focus on overarching population health. Patients expect their healthcare service experiences to match those they receive from tech giants, such as Amazon, Google, and Facebook. US regulations, such as the Interoperability and Patient Access Final Rules offer providers unprecedented and timely access to patient data, and give patients access to their personal health information. These rules mandate that electronic health records data and ambulatory medical records data are shared seamlessly through to claims systems.

In a nutshell. Increasingly, digital marketing strategies are being used to enhance patient engagement. WebMD partnered with healthcare software firm Symplr and, in mid-2021, launched a solution that leverages search engine optimization and trusted content to drive consumers to health system digital front doors for real-time provider searches and appointment scheduling.

Previously, WebMD introduced the feature-rich PracticePro platform to enable medical practices to attract, retain, and engage more patients and help patients find doctors online.

Healthcare players are introducing solutions to cater to patients’ growing interest in finding health information online and through social media.

Impact. Enhanced patient engagement through personalized care experiences will boost health outcomes. Insights-driven personalized care will likely transform the care experience, drive down costs, and enhance access to care. Personalized member engagement will drive medication adherence, enhance clinical outcomes, and overall population health throughout 2022 and the years ahead.

Healthcare sector is now focused on integrated health via a whole-patient approach and understanding SDoH
The care spectrum has shifted from episodic to encounter-based care. Now, interventions consider the patient’s holistic history, including past and present encounters, and social determinants of health (SDoH).

Context. Technology is playing a significant role in making the longitudinal patient record available to caregivers at each encounter. The longitudinal record is a single-patient record, based on comprehensive patient-matching logic, wrapped in a consent-management model. Longitudinal records deliver timely data in a usable, actionable format so providers can deliver effective patient care. Beyond symptoms that lead to a single encounter, technology makes it possible to construct whole-patient data, encompassing past episodes, prescriptions, mental health, and other social determinants, so providers can create personalized care-management programs. Proactive interventions, wellness programs, and care-management programs for targeted patient outreach are becoming more prevalent.

Catalysts. Social determinants of health (SDoH) paint a composite patient picture that extends beyond clinical symptoms. SDoH include data around living conditions, marital status, and political, socioeconomic, emotional, and cultural factors that may significantly affect health. Polychronic patients (those with three or more chronic diseases) represent 5 percent of the US population, yet account for 45 percent of national healthcare costs. Moreover, estimates say that by 2030, the polychronic population will triple 2015 levels. The economic fallout, social isolation, and unpredictability of Covid-19 have led to systemic inequity that fueled the behavioral health crisis.

In a nutshell. Healthcare companies are investing in and sponsoring initiatives to foster whole-patient healthcare. Chinese medical instrumentation developer Mindray launched M-Connect, a platform that integrates data from all medical devices to comprehensively analyze patient information and personalize treatment strategies throughout the patient journey. Non-profit US healthcare system Advocate Aurora Health directed its investment arm to advance whole-person health. Advocate kicked off the initiative with a +USD25 million investment in tele-nutrition platform Foodsmart and acquired Senior Helpers, a home-care and wellness specialist for seniors. Morgan Health, a JPMorganChase subsidiary focused on employee healthcare quality, cost, and equity, invested USD 50 million in Seattle, Washington-based Vera Whole Health, known for its team of primary care physicians, nurses, and health coaches. It is supported by clinics and an integrated technology platform that optimizes whole-person healthcare.

Impact. Digital health service adoption sparked by Covid-19 is expected to continue throughout 2022+ and will accelerate the collection and dissemination of patient information to care provider constituencies to bolster relevant information at the point of care. US regulations around fast health interoperability and price transparency will encourage a free flow of health information, leading to better clinical outcomes. As more community organizations and healthcare practices collaborate, expect more scalable and financially sustainable solutions in 2022 that improve local population health.

Real-time healthcare data and internet of medical things (IOMT) are driving agility in the medical management
Context. Analytics, data, insights, and Internet of Medical Things (IoMT) tools are moving healthcare frontiers from treating a condition to predicting it. Patient stratification – the ongoing data-based process of assigning patient risk status, based on vital health indicators, lifestyle, and medical history – now makes it possible to identify high-cost, high-need patients, and tailor care management efforts to urgent-need populations. Analytics make it possible to construct a complete, individualized patient view that enables a holistic look at each patient’s health journey, including past encounters and other data, including social determinants of health (SDoH).

Catalysts. The global healthcare analytics market is on track to a 31-percent CAGR (2021–2027) to reach USD118 billion. Additionally, the big data medical services market is expected to reach USD 34.27 billion globally in 2022. An aging population, unhealthy lifestyles, and obesity are spurring chronic illnesses, such as diabetes. Therefore, medical service utilization and costs are up, and worldwide healthcare spending is increasing rapidly. Not surprisingly, patients are demanding data-driven, accurately diagnosed value-based healthcare outcomes. Per capita, global healthcare spending is projected to reach USD 1200 by 2030. Meanwhile, the Journal of the American Medical Association (JAMA) reports that 25 percent of US healthcare spending is wasteful – translating into USD 760–935 billion.

In a nutshell. Healthcare providers are collecting real-time data from IoMT devices and other sources, using AI-powered predictive analytics to tailor treatment and efficiently identify at-risk patients. Providers that encourage patients to adopt healthier lifestyles can lower the cost of care and health risks. In California, Anchor Health adopted machine learning technology from Muse to provide more tailored patient treatment. Muse technology assesses and models clinical evaluations, medicines, vital signs, and other pertinent data. It then helps identify patients in critical condition and visibly informs the clinical team. Google Cloud developed Healthcare Data Engine, a tool currently in private purview, to help healthcare and life sciences organizations collect and leverage data from various sources. The resulting insights will enable organizations to allocate resources efficiently, optimize clinical trials, accelerate research, and identify high-risk patients.

Impact. The increased use of data and analytics in 2022 and beyond will significantly shift the needle toward predictive and proactive population health. Real-time data monitoring and analytics will optimize resource planning and operations, predict disease outcomes, forecast patient loads, and proactively detect fraud risks.

Non-traditional players are introducing significant BigTech play in healthcare ecosystem
Context. Non-traditional health system players use their technical expertise and access to vast customer data to build innovative healthcare models. Opportunistic BigTechs are making substantial investments in modernizing healthcare as the industry becomes increasingly consumer-centric.

Catalysts. Competition from new entrants is a catalyst for traditional players to bolster patient engagement strategies. Equipped with robust technical capabilities and access to comprehensive customer data empowers non-traditional players to enter the healthcare space. Hyperscalers can leverage their cloud capabilities to design platforms, compliant with healthcare standards, to support multi-disciplinary care coordination processes.

In a nutshell. BigTechs are tapping into the direct-to-consumer telehealth market to raise their profile in the virtual care space. Amazon launched a telehealth platform, Amazon Care Service, for Amazon employees and other companies throughout the United States. Microsoft launched Microsoft Cloud for Healthcare to offer trusted and integrated capabilities that deliver automation and efficiency on workflows and deep data analytics for structured and unstructured clinical, financial, and administrative data.

Non-traditional players are actively extending wellness solutions through health-data-sharing features. Apple introduced a health data-sharing feature in the latest version of its mobile operating system, iOS, to allow users to share information from their phone’s health app to their clinicians’ electronic health records.

Companies, such as Oscar Health that started as a technology play, are establishing themselves as health plans, with a differentiated offering around accessible and concierge healthcare services.

Impact. Watch for non-traditional players to extend their edge over traditional healthcare players in 2022 while delivering a superior patient experience and agility to serve emerging healthcare needs. BigTech and hyperscalers will target whole patient strategies across wellbeing and mental health, supported by extensive advancements in healthcare workflows. BigTechs will seek partnerships with traditional providers to handle the inherent complexities of healthcare processes.

Healthcare players are on a massive spree of modernization and cloud adoption
Healthcare players are now pushing digital health boundaries and embracing cloud, automation, and artificial intelligence. Realizing the value of collaboration, interoperability, and data availability at the point of care has led to a push for scale and an on-demand tech-based ecosystem.

Context. Health systems turned to technology to swiftly meet pandemic-based challenges of virtual care, coordinated communication, and remote working. Electronic health records (EHRs) had to be enhanced to include interoperability with voice assistants, ambient listening, and conversational AI to drive patient interactions. Digital Front Door, an omnichannel customer engagement strategy, using technology to improve patient experience at every touchpoint in the consumer journey, became a critical social-distancing component.

Catalysts. Telehealth adoption skyrocketed during the pandemic and continues to show robust growth, leading to increased digital relevance. Continuity of care, especially for aging and frail members, required extensive digital and IoMT support. Therefore, modern IT infrastructure and cloud adoption became necessary in the previously manually driven healthcare ecosystem. Additionally, burdens on the healthcare ecosystem, such as slow prior authorization processes, physician/staff burnout, and siloed workflows forced administrators to consider automation and technology enhancements.

In a nutshell. Now, industry players automate EHR access for streamlined patient care, quality monitoring, regulatory compliance, and fewer redundant expenses. San Jose, California developer of robotic process automation software, Automation Anywhere, launched a cloud-based API bot to automate access to electronic health records. As connectivity within and between health organizations becomes standardized, care coordination is expedited and simplified.

Healthcare ecosystem players collaborate to streamline administrative processes – such as prior authorizations – and deliver providers real-time patient data. Health insurer Humana and EHR specialist Epic Systems expanded their partnership to streamline prior authorizations for providers by connecting their software to manage prior permissions electronically and provide Humana member information at the point of care. Insights into medication adherence, past-due medical services, and care coordination for chronic conditions will help providers make medical decisions in real time.

Impact. Cloud-based data storage services administered and maintained by HealthTech firms will enable healthcare providers to reduce IT infrastructure costs. Seamless access to real-time data through modern systems can allow clinicians to derive better insights, and facilitate collaboration across patient health journeys. Patient portals, centralized health records, and mobile health (m-Health) apps will boost patient engagement and improve the care experience. Conversational AI, enhanced data capabilities, device integration, and interoperability will foster industry collaboration, leading to a heightened focus on member-centricity, personalization, and connected care.

Prioritizing pricing transparency enables payers and providers to earn member trust and enable shoppable health care
Transparent pricing strategies and proactive cost disclosure for bundled healthcare services put consumers and clients first by tailoring the cost and quality of care to individual situations, attitudes, and behaviors.

Context. Healthcare administrators can develop consumer-centric products that encourage patient engagement with competitive intelligence and in-depth insights into internal costs.

Catalysts. A review of historical pricing via hospital charge master lists indicates widespread national and regional price differentials for similar services. Crowe Revenue Cycle Analytics data analysis revealed a 297-percent average price differential between the lowest and the highest gross charges per procedure. However, CMS regulations now require that patients have access to easy-to-use online cost estimators. Pricing has been a long-time pain point that directly impacts patient/member experience. Therefore, more providers/payers are improving patient awareness and member literacy about possible prepayment discounts by publicizing details on their price estimate webpage.

In a nutshell. Innovative solutions enable providers to share relevant information in real time, empowering patients to make informed choices. Transparent pricing models improve patient experience while optimizing net revenue and creating innovative care delivery mix models. HealthTech firms are developing solutions to help patients become active in their care process. By enabling multiple options and collaboration with the care team, patients participate in a shoppable experience.

Impact. The trend in 2022 and beyond is price transparency that drives member engagement and allows patient healthcare choices and oversight. Pricing information will spark healthcare ecosystem competition and innovative ways to deliver care, focusing on continuity and coordination beyond hospital settings. A transparent pricing model will enable seamless collaboration between providers and payers, improving manual and complex processes, such as prior authorization. Healthcare providers can better assess their competitive positioning through market assessment of comparative pricing data.

Healthcare ecosystem players are stepping up measures to combat privacy and security risks
As the healthcare industry leverages vast data to innovate personalized patient solutions and enhance operational efficiency, it also faces concerns from members and regulators around data security, privacy, and the ethical use of patient information.

Context. The move to healthcare services delivered through digital platforms – coupled with extensive data exchange made possible by interoperability – providers, payers, and patients are worried about privacy and storage of sensitive healthcare data.

Catalysts. The frequency and severity of healthcare cyber-attacks are up. The healthcare industry is an attractive target for hackers, seeking to monetize sensitive health information in several ways. Cyber-attacks and data breaches can put healthcare organizations at risk and vulnerable to steep penalties that significantly impact business operations.

In a nutshell. Healthcare players are introducing integrated cyber-security solutions to provide end-to-end cyber-safety. Healthcare ecosystem players are collaborating with tech companies to manage and share patient data securely. Blockchain technology is helping to bolster healthcare data privacy and security.

Impact. Patient-centricity and trust are central to healthcare services, and data-security concerns can severely impact patient relationships with the payers or providers. Expect more healthcare organizations to adopt a robust security strategy in 2022 to mitigate potentially huge losses, spurred by data breaches, penalties, and ransomware demands. With a robust security infrastructure, healthcare providers can enable seamless and secure data sharing.

Margin pressures and the transformation of care delivery models have triggered consolidation
As more and more providers deliver care from alternative settings, horizontal and vertical health system integration is becoming commonplace.

Context. As large US health systems add hospitals and expand their market share, smaller systems are forced to consolidate because of rising healthcare costs and pandemic-driven resource shortages. Low-margin providers are vulnerable to acquisition by prominent, more profitable players.

Catalysts. The transition from volume-based to more complex value-based care necessitates cost optimization, diversification, and new revenue-generating avenues. Covid-19 accelerated outpatient and virtual delivery care models and spurred a gradual transition away from inpatient care. Now, health systems are focused on asset portfolio innovation.

In a nutshell. Healthcare ecosystem players are integrating to fend off competitors, increase market share, tamp down healthcare costs, and extend member care. Horizontal integration by healthcare players is broadening service portfolios and capabilities.

Impact. Throughout 2022, we expect US outpatient healthcare and innovative care delivery models to proliferate with optimized asset portfolios across hospitals, virtual health, community care, post-acute, and behavioral health facilities. Hospitals and healthcare providers will gain more specializations, capabilities, resources, and relationships via consolidation, increasing care quality. Highly concentrated healthcare markets that exert their leverage to negotiate higher fees from health insurance providers increase healthcare costs for members and patients. As a result, watch for trends that see regulatory bodies working to curb these practices.

Interoperability continues to outpace innovations in the connected care space
Fast Healthcare Interoperability Resources (FHIR) interoperability standards enable dissimilar systems to connect, which can improve patient access and facilitate coordinated care.

Context. A lack of interoperability and coordination among healthcare ecosystem participants led to inefficiency, high operational costs, and suboptimal patient care. Recently, more providers are adopting Fast Healthcare Interoperability Resources (FHIR) protocols.

Catalysts. Today’s providers have better insight into a patient’s drug history and previous drug interactions, enabling them to transition across the care lifecycle seamlessly. Insights about member health and wellbeing from new data sources, such as wearables data and lab observations, can now be integrated within patient/member records. Medical providers and device developers are promoting patient-data access using third-party apps and APIs.

In a nutshell. FHIR-compliant portals offer on-demand access to healthcare information. FHIR APIs enable firms to bring a variety of data sets together, secure nuanced insights using advanced analytics, and provide better member care. HealthTechs are navigating the complexities in FHIR implementation by developing collaborative solutions that give service providers easy access to the tools and resources required to serve patients better.

Impact. Seamless data sharing will facilitate faster healthcare innovation, enabling operational efficiency, frictionless prior authorization, and similar processes that previously were slowed by information and process silos. APIs enable real-time control over data (rather than periodic feeds) and sharing of relevant information rather than complete medical histories. Large health systems that adopt FHIR in 2022 will harmonize application landscapes and foster coordinated care through FHIR-led effective data exchange and collaboration workflows.

Way forward
Throughout 2022 and the years ahead, dynamic external factors will motivate healthcare providers and insurers to continuously evaluate fundamental value propositions. Expect inalterable industry transformation due to cyber-crime vulnerability, regulatory compliance mandates, high-impact alternative care-delivery channels, increased use of predictive analytics to support wellbeing and disease prevention, and the growing importance of stellar patient experience.

Overall, the healthcare system spotlight will shine less on insurance and more brightly on improved care, outcomes, and constituent experience. Increasing retailization of healthcare services, patient/member quests for convenient, accessible shoppable experiences, and value-based care delivery are on track to change the industry forever.

Paradoxically, Covid-19 forced the health system and regulators to recognize the need for innovation and begin meaningful and widespread implementation.

This article is based on a report by Capgemini.