2022 Predictions: The Winter of Despair followed by the Spring of Hope
My article title is a nod to A Tale of Two Cities — a book I always think of at this time of year because 1) the opening paragraph mirrors the dramatic flair of reflecting on a whole year over the span of the final week, and 2) the line “it was an epoch of belief, it was the epoch of incredulity” has lately seemed all too relevant to the predictable unpredictability of life during the COVID-19 pandemic.
This moment feels like the winter of despair as hospitals surge with COVID-19, the test positivity rate is close to 10% in New York, visitor restrictions are back on at many hospitals, and hospital systems across the country face record staffing shortages.
But my predictions are hopeful. Hopeful in the sense that I hope more so than predict that some of the below will be true. And hopeful in the sense that there was tremendous momentum in 2021 in many spaces of healthcare (e.g. infrastructure, maternal health, vaccines) and I am encouraged that that will continue.
Healthcare dry powder builds for an active 2022, late stage startups institutionalize corp dev activity, and multiples and comps become less of a black-box. There are plentiful predictions on the active M&A environment of 2022. Healthcare entrepreneurial activity abounds. For everything, there is a season, and I anticipate we have a season of further consolidation ahead of us. Large public and private companies are taking note of the magic created by earlier stage startups — the ones that have taken time to listen to patients, providers, and beyond, and have built something incredible. Record fundraising in 2021 has left later stage startups with capital to deploy and myriad opportunities to acquire companies, capabilities, and leaders that will serve as growth accelerants. Integration is always the hard part though. I expect an emerging (and highly prized) skillset for healthcare tech strategy & ops folks will be post-M&A integration experience. Multiples and comps becoming less of black box is definitely more of a hope. I expect we will see more data emerge around sub-sectors in healthcare as well as more nuance between multiples that are appropriate for practice acquisitions vs. tech enabled care delivery co’s vs. healthcare SaaS plays.
Continued investment in solutions that identify, evaluate, and deliver targeted, compassionate interventions for a rising social risk population. Super-utilizer probability is predicted based on past medical encounters. But the social rising risk population likely flies under the radar of health systems. These individuals are experiencing social hardships (e.g. evictions, domestic violence, isolation) and it is possible and probable that these hardships make underlying medical conditions worse or cause net new health issues. The below 2x2 from Right Sizing Prenatal Care to Meet Patients’ Needs and Improve Maternal Care Value offers a mental model for how to evaluate patients’ needs on the medical and social side.
As opposed to grouping all patients in one quadrant (image C), I am hopeful that 2022 will bring growth for companies phenotyping patients by medical and social need (image D) and building out appropriate social supports (e.g. group support, temporary housing, food.) I am particularly excited to see how the Unite Us — Social Current collaboration plays out in 2022. Venture capital investing in companies that deliver social supports to address the social rising risk category or more broadly, that address SDOH is challenging given that the anticipated returns timeline may exceed what is typical for funds. I wonder if we will see venture philanthropy (where non-profits fund for-profit company activities) take root in this space. There’s been success to date between biotechs and disease-focused foundations using a venture philanthropy model, and I’d be interested to learn more about similar non-profit funding initiatives for SDOH.
Build Back Better creates much-needed attention and momentum in maternal care despite legislative uncertainty. Vice President Kamala Harris brought together a cross-functional group for the first ever Maternal Health Day of Action in early December and announced several funding initiatives, including $3B as part of Build Back Better. Thrilled to have a VP championing women+’s health and health equity. I was excited to see sizeable commitments from non-profits, corporations, and startups, alike listed here. Notably, CVS is planning to deliver virtual childbirth education classes, Happy Family Organics will be delivering prenatal nutrition guidance to support perinatal health, and Sage Therapeutics will look to expand its maternal mental health program to 250k parents. We will see these commitments come to fruition in 2022. There are other areas of Build Back Better that would benefit from similar public-private partnership to accelerate access to care (e.g. direct care workforce support, palliative and hospice care training, public health infrastructure.)
Community Health Workers, long underutilized and underinvested in, begin to see further integration into care ecosystems. Many of the maternal health commitments for the non-profit sector as part of the Maternal Day of Action revolve around funding and operationalization of community-based solutions and community health workers. I’ll be watching the “training and deployment of CHWs” space very closely. Families USA’s Community Health Worker Sustainability Collaborative is focused on driving utilization of CHWs and funding for training programs. I’ve thought in the past that we need to find a way to create a scalable, “Edward Jones” type model for CHWs. For those unfamiliar, Edward Jones’ expansion strategy revolves around training individuals who had a certain level of trust in a community to become investment advisers. In a similar vein, how can we proactively identify individuals who are respected and trusted in a community to take on a role for health promotion? We have critical gender and racial disparities in care delivery — CHWs can play a role in delivering culturally congruent care and addressing primary care shortages. There are many examples of organizations that are currently doing this effectively (like Live Chair) as a way of supporting participatory health promotion.
Diagnostics and med devices power telehealth experiences. Gene-informed primary care is coming, maybe. This one is pretty self explanatory. Health data is good but action steps and expert content in relation to your healthcare data is better. It is also probable that guidance that feels personal to you and your biology will yield better patient activation and better adherence. Some data will become a commodity as diagnostic access improves so care delivery integration can become a part of a diagnostic co’s moat. One area we may see this take form is virtual primary care…will 23andMe launch a gene-informed, virtual first primary care clinic post their acquisition of Lemonaid? Let’s see. The Invitae-Ciitzen acquisition disclosure documents were fascinating and hinted at their role in fostering genome-powered healthcare and molecular medicine.
Impactful progress in patient care and social interventions for cognitive decline, Dementia, and Alzheimer’s Disease. One need only look at the SBIR and NIH grants repository for 2021 to see the immense scientific attention dedicated to finding a cure for Alzheimer’s. There are various grants for patient monitoring, care management and financial planning, early disease detection, novel treatments, caregiver support, and virtual social support. While not quite as buzzy as drug launches, I am hopeful that the work put in throughout 2022 by these teams will yield innovation that will come to life in 2023 and beyond.
2022 will be a banner year for new care models in women+’s health. I both believe this to be true and am manifesting this as part of creating the future I want for the health of women+. Lots of interesting acquisition activity in 2021 that I anticipate will result in new opportunities to improve the health of women+. We saw the acquisition of Modern Fertility by Ro, the acquisition of Ovia by Labcorp, and the acquisition of Natalist by EverlyHealth. I anticipate we will see the launch and expansion of full spectrum, virtual-first women+’s health clinics. Diagnostics and products (like Modern Fertility & Natalist) offer a golden window of activation for broader health promotion and both have strong community followings that they bring to their acquirors. Big fan of Modern Fertility’s slack community and Natalist’s instagram :) Ovia is a different type of acquisition and signals Labcorp’s interest in expanding further into women+’s health. I am excited to see how Ovia integrates with Labcorp. They’ve built an incredible content and coaching platform. I imagine Labcorp will use fertility and maternal lab testing (and beyond) to introduce new patients to Ovia and vice versa.
Healthcare (Taylor’s Version). Healthcare is feeling (20)22. Simone Biles as Chief Impact Officer for Cerebral, Olivia Rodrigo promoting vaccines at the White House — youthful celebrities are part of public health and I am into it. I predict we will see more celebrity and youth engagement in public health in 2022. As adolescent mental health emerges as a critical challenge in our society, we will see more champions willing to talk about and normalize health struggles.
I think many of us in our 20’s and younger feel that COVID-19 has had a huge impact on our outlook on life. The health of our communities (and equity in achieving our highest levels of health) will be the work of our generation. Med school and Master’s of Public Health applications are skyrocketing. Millennials, Gen Z, and Gen alpha are going to put a “Taylor’s Version” spin on the care ecosystem.
With that, cheers to the Spring of Hope. I am inspired everyday by the mission-focused, brilliant people I meet in this healthcare and digital health world.
Reminder: Opinions my own.
