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by John Moore | December 13, 2022

2022 Wrapped Up

Time for our annual review of the predictions we made for 2022. For the year, we had a hitting average about .750 — impressive, don’t you think? Well, from my chair, not so much; I found most of these predictions to not be all that risky or profound. But we do have a new year rapidly approaching, and I’ll be pushing myself and our analyst team to take more risks in 2023 with regards to their predictions.

HIT — Intra-industry collaboration will develop to build stronger governance frameworks for AI.

In 2022, the industry coalition CHAI (Coalition for Health AI) was formed to address the myriad of issues associated with the use of AI in the healthcare sector. CHAI’s expressed aim:

“Our mission is to provide guidelines regarding an ever-evolving landscape of health AI tools to ensure high quality care, increase credibility amongst users, and meet health care needs.”

CHAI represents a broad cross-section of industry stakeholders from health systems such as Mayo Clinic, Stanford and Johns Hopkins to Google, MITRE and Change Healthcare as well as a number of federal agencies.

MISS US Digital Health solutions will see more growth opportunities internationally than domestically.

The global economy in 2022 soured quickly with the advent of the war in the Ukraine, inflation, and an economy still recovering from the COVID pandemic. This constrained the ability of US-based digital health solutions from penetrating new markets overseas. This is unlikely to change in 2023, though we may see some progress in the 2024-25 time frame.

However, what we are seeing here at Chilmark Research is a slightly different expansion: international (mostly European) digital health solutions are looking to penetrate the US healthcare market, which remains the largest global market for these solutions.

HIT Land grab for provider practices, esp. PCPs as retail (CVS, Walgreens, Walmart, Dollar Stores) scales up GTM strategies.

Not only primary care, but all high-quality, independent, ambulatory care practices are being besieged by offers to sell their practices. This has been an ongoing trend for the last several years with no sign of a let-up. United Health Group, through its Optum division, had the most physicians on salary (60,000) at end of 2021. They’ve gone on to add another 10,000 in 2022.

With current margins in the dumps for most health systems, their ability to compete for those practices (along with regulatory hurdles) leaves them on the sidelines.

HIT  Analytics solution vendors bifurcate solutions to serve two markets.

We are seeing this begin to occur, albeit slowly. As it turns out, even those health systems that have invested heavily in data analytics personnel still struggle with understanding and interpreting the data. What we are beginning to see is analytics vendors providing far higher service components to their offerings. For example, Health Catalyst, one of the analytics leaders, is aggressively pursuing strategic outsourcing deals with provider organizations, announcing its latest win on Dec. 5th with Illinois-based Carle Health.

HIT PHM is Dead, Long Live VBC

Not very proud of this lazy prediction as it is fairly simplistic, vague, and has an easy-to-guess outcome. Yes, it is more or less true, but if there was ever a throw-away prediction, this would be the one.

HIT  SDoH vendors with deep pockets from 2021 investments struggle to demonstrate ROI on par with those investments.

SDoH vendors are getting squeezed. UniteUs has yet to demonstrate convincing results, despite a very large investment, and some in the industry are seriously beginning to question whether or not UniteUs will survive the current downturn if it extends deep into 2023. Contributing to all of this is the often-overlooked complexity of the field. Coupling that with the immaturity of these technologies, lack of sufficient workflow capabilities, etc. makes early, demonstrable ROIs challenging.

MISS   Digital and hybrid digital/human navigation services will expand in offerings for employers.

This may have been our biggest miss and biggest mystery. Care navigation solutions appear to have a strong value proposition for employers: Guide employees in choosing appropriate venues of care for what ails them. Looks like low hanging fruit to us. However, reality can be far different from logic and vendors in this realm are struggling to survive as employers cancel contracts due to no perceived ROI. Accolade’s loss of one of its largest clients, Comcast, who also invested early on in Accolade says it all.

HIT Cloud wars pick up the pace.

With Oracle’s acquisition of Cerner to drive its vertical industry approach to cloud platforms we’ve added another competitor to the healthcare platform mix which has been dominated by Amazon Web Services (AWS), Microsoft’s Azure and Google Cloud. These four will continue to lead this industry forward in its cloud migration but expect users to take a multi-cloud approach, leveraging specific cloud services based on need and business use case.

HIT Behavioral health will lead virtual care solutions.

Despite the fall-out of hybrid behavioral health-pill mill vendors such as Cerebral, behavioral health remains the absolute leader in telehealth services by a long-shot. While other telehealth services have come back down to earth from their previous COVID pandemic highs, telehealth-based behavioral health have maintained their 60+ percent level of all services being delivered via telehealth. 

HIT Significant increase in acquisitions in the AI for operations (AI4Ops) sector.

The year led off with Bain Capital purchasing Lean-TaaS, a vendor who we found to have an impressive solution suite and was profiled in our AI for Operations report that was published in 2021. This is only the beginning, as there remain quite a few mature solutions in the market today and new vendors coming forward with regularity.

MISS  IPO market for health IT companies will be very active.

Walking into 2022, we knew of several health IT companies that were making preparations to do an IPO in the coming year. Those best laid plans are now in the waste basket, as these companies await a more favorable climate economic climate than the one we are in currently.

MISS Consumer organizations begin organizing in response to the secondary uses of health data, pushing for more direct control of their health data and how it is used.

The techlash raised awareness of personal data and its commodification. Our personal health information is the most personal of all. However, consumers are still taking more of a laisse faire attitude towards this data and how it is shared. This will likely change in time, but not this year or next or the one after that.

Just Kidding Walmart goes all in on healthcare services.

Continuing to roll out their health strategy, Walmart will announce that sections of selected Walmart Supercenters will feature by-the-hour reservable hospital beds and self-service ambulatory surgical options.

In closing, may the new year ahead bring you good health and joy, mixed in with your favorite predictions becoming reality.

Stay tuned to this channel as well for our 2023 predictions are under final review and be published within next week or so.

John Moore, Founder, Chilmark Research

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