Health Care Trends Expected in 2022

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An upside to the continuing issues associated with the COVID-19 pandemic has included attention to some issues that were previously ignored. In 2022, expect more of these “silver-lining” trends to continue. For instance, the innovations and the adoption of telehealth and telepsychiatry that started in 2020 will continue in 2022, even if the peak use of telehealth has tapered. Clinicians and insurance payers are continue to move “upstream” to the social determinants of health (SDOH), investing in housing, transportation and other factors that affect people’s health but are outside of traditional health care.

Also expect continued efforts to address health care disparities. Disparities in outcomes and access are deeply rooted problems that lend themselves to a population health approach—but not to quick fixes.

Telehealth and Telepsychiatry

It has been almost 2 years since COVID-19 forced a telehealth revolution, and patients now expect live video interaction offerings from their health plans and clinicians. Telehealth, which once meant having a live video visit with a physician, has become a commodity, with hundreds of options now available to patients, explained Sebastian Seiguer, JD, MBA, CEO of emocha Health, a medication adherence company in Baltimore that is a Johns Hopkins spin-off. Simultaneously, the very definition of “telehealth” is changing, as both patients and clinicians have increased comfort with a variety of digital tools such as texting, online portals, and artificial intelligence (AI)-powered chatbots that provide personalized health care advice and support.

Jessica Sweeney-Platt, vice president of research and editorial strategy at athenahealth in Watertown, Massachusetts, expects virtual care to continue to evolve, as it expands from a reactive mode of handling sick visits to incorporate proactive, convenient, preventive care. This is particularly true for patients working with care teams to manage chronic illnesses. In tandem, wearables, which provide the ability to monitor health at home, will gain popularity.

Similarly, an increase in home monitoring options is coming online with on-demand electrocardiograms, continuous glucose monitors, and other opportunities for people to actively engage in their health care, reported Nina Birnbaum, MD, medical director of innovation acceleration at Blue Shield of California. These tools could help physicians better determine what diagnostic workups and treatments are needed, and potentially lower costs.

Companies are also looking to amplify existing models of in-home care with technology. A company called Heal is looking to bring back house calls; Papa Health provides health care worker visits and general help at home for lonely older adults; and Ready offers in-home urgent care visits. These are just a few examples of emerging categories, with some players overlapping and others defining entirely new segments, Seiguer added.

In addition, telehealth can enable a hesitant or time-constrained patient to access care conveniently and quickly, helping to catch disease progression earlier and ultimately prevent small problems from becoming big ones, explained Karen Ignagni, president and CEO of EmblemHealth in New York, New York. Telehealth also helps to manage chronic conditions and treatment adherence by providing simple, quick ways for people to check in with their clinicians.

More good news is that the government is beginning to recognize the benefits of telehealth and, more broadly, care that is delivered remotely and digitally. CMS provided reimbursement guidance for a new category of digital health—remote therapeutic monitoring—in early November 2021 that compensates providers for caring for patients outside of a physician’s office. Health care professionals have not had a financial incentive to ensure that their patients understand and take their medication completely and properly. These new remote therapeutic monitoring codes provide reimbursement for the kind of support that can lead to greater adherence, Seiguer said.

Tackling Social Determinants of Health

Expect a greater focus on analyzing barriers to care at the population level and then investment in community programs that can have the greatest impact on the most people as an emerging trend. Sweeney-Platt said that providers and payers both have obstacles to overcome.

“While provider organizations are driving these conversations—especially those who have taken on Medicare Advantage or managed Medicaid risk—they don’t always have the resources to build programs,” she observed. “Payers have also invested in these types of programs but have struggled with low adoption. This leaves a lot of opportunities for payer and provider collaboration.”

Experts note that SDOH present issues that cannot be solved peripherally. “Successful organizations are those that can marry sophisticated network-level analytics in order to identify hot-spot practices with common sets of needs, with deep local knowledge of community resources and partnerships,” observesdSweeney-Platt.

She added that compensation is among the biggest challenges: determining who pays for these programs. Robert Bollinger, MD, MPH, a professor of infectious diseases at the Johns Hopkins University School of Medicine and one of the inventors of the technology licensed to emocha Health, said health care institutions should engage in strategic public-private partnerships with government and nongovernmental programs (eg, Medicaid, community/faith-based organizations) to address SDOH issues. He also said institutions need to push for more resources to support SDOH efforts.

The Disparities Dilemma

Related to SDOH is the need to close health care disparity gaps. Bollinger said it is important to remember that any population health effort to address SDOH must also take into account racial discrimination—in society in general as well as in health care. He listed some steps that health care entities can take to begin to deal with disparities:

- Prioritize the measurement of and report health disparities based on race and other SDOH factors within clinics, facilities, digital programs and among providers.

- Build meaningful partnerships with trusted community partners (eg, churches, local politicians) to enable patients to play significant roles in developing solutions that are meant to address these disparities.

- Make racial equity a strategic priority for the organization. Many organizations are emphasizing and implementing training, cultural competency, or workforce diversity initiatives. However, training alone is not sufficient. “Equity needs to be more than a standing topic for every C-suite meeting, leadership meeting, and program,” Bollinger said.

Along those lines, Christopher Dodd, MD, chief medical officer of PopHealthCare in Franklin, Tennessee, and its home care business, Emcara Health, said they deploy home care teams that include culturally aligned community health workers. “This approach enables us to build trusting relationships with underserved community members,” Dodd explained. This model, along understanding the social and environmental factors affecting health, helps to prevent serious and costly health issues before they arise, he added.

Ms Appold is a medical writer in the Lehigh Valley region of Pennsylvania.

A version of this article originally appeared with our sister publication Managed Healthcare Executive.