Top 10 Healthcare Industry Predictions For 2023

The year 2022 is almost behind us and the healthcare industry is preparing for what promises to be a most interesting 2023.

Deals—big and small—and increasing regulatory scrutiny will make 2023 a year to remember for all.

Given the prescience and accuracy of my 2022 predictions, many of you have asked about my methodology.

If you must know (and seek to remove the mystery of it all), it’s pure clairvoyance—a divine gift with which I was born.

Joking aside, some predictions are pure hunch; others are extensions of trends observed in 2022 that will continue into 2023; and others still are a reflection of my deepest hopes—some of which I hope I will nudge into being by writing it here in this column.

Without further ado, I give you the year ahead in healthcare, 2023 edition:

1) Medicare Advantage Will Remain Under A Microscope

I predicted last year that that the Medicare Advantage debate that my mentors Don Berwick and Rick Gilfillan started in 2021 would intensify. The year 2022 didn’t disappoint as Don and Rick used the pages of the Health Affairs blog to spar with numerous Medicare Advantage defenders including heavyweights WellBe Medical CEO Jeff Kang, former Kaiser Permanente CEO George Halvorson, and former CAPG CEO Don Crane. New York Times writers Reed Abelson and Margot Sanger Katz followed on with a provocative set of articles on Medicare Advantage utilization management practices; revenue capture; and broker practices. The microscope is turned on and examining Medicare Advantage in high resolution—and this scrutiny will continue deep into 2023.

As the CEO of Medicare Advantage plans for 7 years running, I have strong conviction that the Medicare Advantage is an important program that enables innovation to serve older adults, but also acknowledge that there is significant room to improve it. To address some of the emerging skepticism of Medicare Advantage, plans should proactively implement more stringent revenue coding practices; commit to access-to-care “never events” to ensure beneficiaries always have access to care in a timely manner; and continue to enhance the quality of benefits delivered through their products. The best answer to the critics is to be irrefutably and consistently better for Medicare beneficiaries—and that is the challenge to all companies that operate plans.

Whether the pundits find value in the program or not, it is here to stay—as more than 40% percent of older adults rely on it for their care. Our focus should be on aligning on ideas to improve the program, not arguing whether it’s better or worse than traditional fee-for-service Medicare (as with most things, the answer is, it depends). The leadership of the Centers for Medicare and Medicaid

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Hunting ahead to 2022: 12 healthcare execs give their predictions

The changes brought to the market in 2020 amid the pandemic ongoing to weigh on the minds of health care executives in the course of 2021.

And, as they glimpse ahead to the coming 12 months, they are anticipating identical themes to have ahead: desire in digital care, the ongoing pandemic response and a greater concentrate on patients’ social needs. 

Associated: 2022 forecast: 7 predictions for what lies in advance for wellbeing equity

Hear from 12 market leaders on what they are watching in 2022:

Milan Shah, Biofourmis chief technology officer
Milan Shah (Biofourmis)

Milan Shah, chief know-how officer at Biofourmis

Regardless of what transpires with the pandemic future yr, the change to virtual treatment and care-at-household will carry on to accelerate. Beyond telehealth visits, 2022 will see increased adoption of healthcare facility-at-home and distant affected individual management for the reason that health care companies have viewed how feasible it is, and payers are recognizing the inherent price price savings. Most importantly, sufferers significantly favor to be at household in its place of a medical center and all stakeholders are recognizing that best results can be achieved outside of a clinical facility. That change indicates healthcare corporations will need to operate carefully with virtual care suppliers to guarantee their networks—and patients’ personalized overall health info (PHI)—is secured from any vulnerabilities.

John Schwartz, chief revenue officer of HSBlox
John Schwartz (HSBlox)

John Schwartz, chief income officer at HSBlox

COVID-19 has centered a sharp lens on the state of wellbeing inequity within our present-day health program and uncovered the worth of incorporating social overall health prerequisites. With care growing outside the house the 4 walls of a hospital and the require for incorporating SDOH, the administration of value-primarily based treatment contracts will arise as an crucial industry issue to address in 2022. This price-centered administration cuts across all treatment settings—traditional web page-centered, virtual, in-home and in-the-community—and permits total-man or woman care via the concurrent orchestration of health-related and nonmedical care shipping and delivery and services belongings into high-performance networks. To be profitable, even so, stakeholders will need to seize and share details on a permissioned basis as well as compensate associates in these contracts who earlier have not been aspect of the standard health-related community.

Michael Dulin, CMO of Gray Matter Analytics
Michael Dulin, M.D.
(Grey Matter Analytics)

Michael Dulin, M.D., chief health-related officer at Grey Matter Analytics

All people in a wellness process who engages with a client or participates in the individual practical experience has a accountability underneath benefit-centered treatment contracts. In 2022, ideal-follow health and fitness programs will incentivize their employees and clinicians as properly as sufferers to examine and doc social determinants of well being (SDOH)—from the entrance doorway to inpatient discharge planning—as vital to patient health and fitness and results. Further, value chain wondering will speed up the proliferation of social courses to handle SDOH, from food stability to housing to childcare, work and transportation. The most successful initiatives will enlist people in software structure and analysis and include their feed-back on no matter if and how they will use assets from neighborhood organizations.

Richard Brooks, Connect America
Richard Brooks (Connect
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