Top 4 Challenges Facing Health Plans in 2022 and How to Overcome Them

From network development and staffing shortages to managing relationships in an increasingly digital world, health plans have a lot on their plates in 2022. How can leaders effectively navigate this difficult environment while continuing to provide exceptional services to members?



Since the beginning of this tumultuous decade, health plans have been confronted with an unprecedented array of challenges. At the start of 2022, COVID-19 is still sending shockwaves through the payer landscape, affecting everything from clinical spending trends and network development targets to where internal teams spend their workdays.

This year, as organizations start to get comfortable with the new normal, health plans have the opportunity to take stock of their situation and ramp up implementation of effective, data-driven solutions.

We asked experts from growing commercial and Medicare Advantage health plans about the top issues facing their organization…

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Innovation is no longer optional for established health payers and digital native startups. Without revamping inefficient processes, payers risk falling behind in the race for provider participating providers and market share.
Here are the first steps payers can take on the path toward sustainable, successful innovation.


The health plan marketplace is evolving quickly as changing demographics, new regulations, and cutting-edge technologies sweep away the status quo. Both commercial health plans and Medicare Advantage (MA) plans are seeing increased competition for visibility and market share, especially as consumers become more and more savvy about their preferences and needs.

But are internal health plan operations innovating at the same rate? Unfortunately for many payers, the answer is “no.”

Even as an emerging class of fresh-faced, digital-first payers and direct-to-consumer (DTC) telehealth companies rises up to challenge the notion of business as usual, a worrying number of payers are still relying on manual processes and fragmented workflows for network development and maintenance. As a result, they are missing out on key opportunities and creating frustration for internal stakeholders and their external partners.