Top 10 hospital and payer trends to watch in 2023

As 2022 comes to an end, Healthcare Finance News editors reflect on how much has changed over the past year and what that means for trends in 2023. The public health emergency is ongoing and will remain in place past January 11, 2023, putting the popularity of home health and telehealth in the balance. Hospitals continue to see surges, this time from a combination of COVID-19, flu and Respiratory Syncytial Virus; CEOs and CFOs carry on juggling finances, inflation, increased expenses for labor as well as shortages and the need to determine investments in digital health, AI and automation. And, as always, the demand for interoperable systems and price transparency grows.

Here are the Top 10 trends from 2022 that are likely to influence hospital and payer decisions in 2023:

• The end of the public health emergency: What happens next?
• Technology, digital health and automation: Strategies to streamline, reach patients and goals.
• Hospital finances: Cutting expenses, where to save?
• The retail competition: Amazon, CVS, Walgreens, UnitedHealth move into primary care.
• Payers: Meeting the Transparency in Coverage rule that goes into effect January 1, 2023.
• Hospital at home checks the boxes: an aging demographic and a less expensive alternative.
• Medicare Advantage: Who's in, who's out?
• Telehealth: Fad or future?
• Mergers, acquisitions and partnerships.
• Interoperability for providers and payers.

See the stories below to take a closer look at how and why those trends will continue into 2023. Then check back on this page every week through the end of the year for more coverage.

Shift to virtual care not dependent upon payment parity, says TytoCare CEO.

Telehealth done right can bring down the total cost of care by 10%, says TytoCare CEO Dedi Gilad.

Siloed technology and data create a big health system pain point.

Healthcare executives told KLAS they don't feel confident tackling this issue.

Digital health advances end with the PHE.

Unless Congress acts, patients and physicians are going to lose out on digital health innovations allowed by PHE waivers, CHI says.

Telehealth payment parity only good through 2023.

The omnibus spending bill continues telehealth waivers for two years past the PHE, but was silent on the issue of reimbursement.

Geisinger at Home offers primary care to populations with chronic or complex conditions.

"We have seen a $400 per member, per month improvement in patient total cost of care," says CMO Jonathan Welch.

HIMSSCast: The financial pressure for hospitals is not abating in 2023.

Focus on what you can control, say Alvarez and Marsal Managing Directors Peter Urbanowicz and Martin McGahan.

Telehealth utilization has declined almost 4%.

The decline was larger than the national average in the South, Midwest and West, and there was an increase in the Northeast.

Amazon Business offers hospitals a supply chain alternative.

The B2B arm of Amazon is targeting the 20% of hospital nonclinical spend.

HIMSSCast: To cut expenses, hospitals should look at indirect spend.

Reining in the 20-25% of revenue that goes to nonmedical spend could save hospitals millions, says Brain White of LogicSource.

HIMSSCast: C-suite is concerned about inflation and affordability.

Hospital leaders can use digital transformation to cut costs, improve processes and gain efficiencies, says Tina Wheeler of Deloitte.

Payers harnessing data to get ready for Transparency in Coverage requirements.

When the next phase of the final rule's rollout occurs in January, payers will need to be ready for a new world of price transparency.

Merger and acquisition deal volumes to continue increasing, PwC finds.

Home health and hospice continue to drive transaction value this year.

Telehealth's future after the end of the public health emergency.

Congress has numerous bills, questions on cost and a "boatload" of data for CBO to sort through.

Up to 18 million people could lose Medicaid coverage after COVID-19 PHE.

Findings suggest the result could see the largest changes in coverage since the ACA came into force more than a decade ago.

HIMSSCast: Geisinger's automation strategy frees clinicians to spend more time with patients.

Bots prompt nurses after taking care of redundant tasks and patient audits, says Emily Fry, VP of Innovation Operations.

Revenue cycles challenged by mandates of No Surprises Act.

A "horrible policy failure" over disputed claims backlogs is added to mandates requiring an advanced hospital infrastructure.

Top reason for delaying care is now cost, not COVID-19, patients say.

Hospitals must aspire to ease care access, says Cleveland Clinic physician and Qualtrics CMO.

Humana plans CenterWell expansion of 30-35 senior primary care clinics.

Photo courtesy CenterWell Senior Primary Care

Its Primary Care Organization will continue to grow by 30-50 centers per year through 2025, Humana says.

Lacking notice, hospitals can expect PHE to extend beyond January 11.

Photo: Violeta Stoimenova/Getty Images

The deadline for HHS to give providers a 60-day notice was Friday.

Health systems need to balance their service offerings against dwindling financial resources.

Hospitals' service line rationalization is that they are like department stores, all things to all people.

Oscar Health and Bright Health are curbing MA expansion, for now.

Bright Health is exiting the ACA market to focus on ACO Reach, and CEOs at both companies are looking at partnerships.

Walgreens-backed Village MD to acquire Summit Health-CityMD for $8.9B.

The deal is being made with investments from Walgreens Boots Alliance and Evernorth, the health services subsidiary of Cigna.

Patients satisfied with virtual primary care, though more work needs to be done.

Nearly four in five Americans said virtual primary care allowed them to take charge of their health, the survey showed.