Healthcare & Life Sciences

2022 predictions for payers in the Healthcare industry

Healthcare payers face a challenging year in 2022, as the pandemic persists and market changes accelerate. Cyber security risks continue to grow, and a new generation of professional ransomware attackers are focused on healthcare. All these challenges highlight the impetus to use every bit of available data to create security, trust and engagement so payers can better anticipate members’ needs and drive improved health in the year ahead.

Specifically, here are my 2022 predictions for payers in the Healthcare industry.

Cyber risk and regulatory challenges fuel security investments

Leading payers in search of more secure, resilient operating platforms are accelerating their movement to the cloud. Healthcare has found itself in the crosshairs of global ransomware gangs. The high value of healthcare data, coupled with limited investments in security, have led to a situation where frequent, institution-wide attacks are regular features in the news. Sophisticated payers are beginning to evaluate high-security cloud platforms as an alternative to large on-premises deployments. Working with cloud partners allows significant improvements in security, while reducing total liability to the healthcare payer. Advanced end-point security is also a growing investment priority, and investigations and forensic analysis technology will become necessary as the complexity and severity of attacks increase.

Integrating coverage of behavioral and physical healthcare becomes a priority

During the early days of the pandemic, payers experienced a significant uptick in claims for behavioral health. For example, Blue Cross Blue Shield of Massachusetts saw a surge of visits driven by demand for mental healthcare, and the number of telehealth claims rose from 200 per day in February 2020 to 38,000 per day in May 2020. In a nine-week period, the health plan recorded more than 1 million telehealth visits. Nearly half of its claims for the early months of the pandemic were related to behavioral health. Integrating behavioral health with physical care allows for a more holistic focus on the patient. With increased engagement, buyers create better outcomes which often lowers the total cost of care. Value-based care organizations and integrated delivery networks will lead this charge as they try to capitalize on the benefits of more integrated care models.

Telehealth will continue to expand in primary, behavioral and occupational health

The rapid expansion of member engagement and telehealth capabilities has demanded new technologies be added to the portfolio of critical systems. Investments in cloud, security and experience management will remain front and center as healthcare payers move off legacy platforms to better compete and meet members’ needs. Expanded telehealth support will also fuel additional opportunities to improve member value through remote monitoring, hospital-at-home and hospice-at-home options.

‘Virtual-first’ health plans gain popularity with members

Virtual-first health plans support telehealth from the first encounter for members, and   telehealth becomes the primary source of engagement with the provider. These plans leverage a digital front door as a key value proposition, allow rapid access to care, and when necessary, transitions to in-person treatment. Members are seeking more virtual offerings as a result of positive telehealth experiences during the pandemic, and many may not want to return to traditional, in-person only options. Payers are finding that virtual-first offerings are more convenient for members, drive a higher quality of care, generate better outcomes and reduce overall cost of care. This is a winning offer and we should expect it to accelerate investments in security, cloud, telehealth and data integration.

2022 looks like another year of technology-driven transformation in health, with the services members seek requiring significant investments in security, experience, engagement and automation. The payers that can quickly bring these capabilities to market will have clear advantages in the years to come.

Learn more about how OpenText solutions for Healthcare can help your organization.

Scott Lundstrom

Scott is a long time industry analyst, CIO, and software developer supporting complex regulated businesses in healthcare, life sciences, and aerospace. Scott founded the health industry practice at IDC Research and lead this group for 13 years. Scott also held leadership roles in research focused on AI, Cloud, SaaS, enterprise applications and analytics.

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