Predictive Analytic Trends to Watch in 2022
This past year brought radical shifts to traditional care pathways, digital health and wellness, and efforts to break down social barriers to care.
As we say goodbye to 2021, our experts are looking ahead by laying out what will be top of mind for healthcare leaders in 2022.
Wes Smith, Senior Vice President, Advisory & Consulting:
There will be three big areas of focus: controlling specialty pharmacy costs, management and prediction of high cost claimants, and mechanisms to connect healthcare data to make it more actionable.
- Specialty pharmacy continues to grow at a significantly higher trend rate then non-specialty, and now makes up over half of pharmacy spend for most plans. With a full pipeline of high cost therapies, some in the millions, there will need to be continued focus on the procurement, authorization, management, and outcomes of specialty drugs – through both the medical and pharmacy channels.
- High Cost Claimants just keep getting costlier – and continue to pose challenges for plan sponsors and health plans alike. A growing area of interest is the prediction of high cost claimants, allowing for earlier intervention and treatment where possible. There will also need to be continued effort around proper management of high cost disease states.
- “Connecting Data” seems to be all the rage, but at some point, there needs to be less talk and more action. A primary mechanism for doing so is a data warehouse. I see more interest in the use of data warehouses to connect not just traditional sources of data (e.g., medical and pharmacy), but also non-traditional sources of data, such as point solutions. And with this, more emphasis on properly leveraging connected data to positively affect member health and outcomes.
Jessica Kinnick, Senior Vice President, Client Deployment & Adoption:
Customers and healthcare predictive analytic vendors have found new ways to collaborate in the post-pandemic environment. The digital alternatives that were necessary in 2020 and 2021 will continue to offer value, efficiency, and an overall better customer experience in 2022. Successful companies should strive to offer solutions that meet emerging client needs including in-person, digital, and self-service alternatives.
Rob Dwyer, Chief Data Scientist:
In 2022 we’ll see a big shift in focus toward data. At Certilytics, we are consumers of data; aggregators, organizers, and enhancers of data; and ultimately vendors of data in the form of analytics.
Consolidation is a perennial theme in healthcare at every level, and this affects data as well. Staying ahead of market trends will mean finding a greater variety of data sources, training measures and models not only to use new data sources but also to be resilient to data incompleteness, and finding ways to monetize data streams in new ways, whether that’s helping our own clients sell their data or turning our own analytic engines into bite-sized APIs to broaden our base of end users.
Andrew Ottum, Executive Vice President, Chief Business Development Officer:
The pandemic has propelled social determinants of health from an abstract topic of conversation into strategic investments aimed at improving healthcare access and reducing the total cost of care. In 2022, these investments will become a top priority, particularly in regard to data analytic tools that enable healthcare organizations to not just quantify and predict SDOH risk, but demonstrate the best ways to mitigate that risk.
The pandemic has also underscored the importance of personalized care strategies that meet a member with the right resource at the right time. Traditional analytic tools often leave healthcare organizations reacting to high-cost, avoidable events rather than preventing modifiable risk. Healthcare leaders will continue to invest in advanced predictive tools that enable treatment pathways tailored to a member’s specific healthcare needs and preferred outreach methods.
If you’re interested in learning more about our AI-enabled approach, contact us for a free consultation with our team of experts or see for yourself how we’ve helped healthcare organizations save $200 PMPY.