The health care landscape: Looking back at 2022 and ahead to 2023

The year 2022 is behind us, and although we began last year hoping for a gradual return to normal after two years in a public health emergency, we continue to feel reverberations from the pandemic. Continued health care provider staffing shortages, a mental health crisis and surging drug overdose deaths have dominated headlines. After a review of the 2022 landscape in health and health care last year, here are some of my highlights:

1. A Pandemic Hangover: COVID-19 continued to be a driver of hospitalizations and deaths among Arkansans and will likely be the third leading cause of death for the third straight year, behind only heart disease and cancer. Misinformation continued to impact prevention of and treatment for COVID, and COVID combined with influenza and respiratory syncytial virus, or RSV, created what has been called a “tripledemic.”
2. An Omni-Boost: The end-of-year omnibus budget bill passed by Congress included major health care-related provisions — extension of telehealth flexibilities for Medicare beneficiaries and safety-net providers for a defined period beyond the public health emergency; protections for breastfeeding workers; funding for mental health, substance use disorder and crisis response services; and requirements for states to keep children continuously enrolled in Medicaid coverage for 12 months.
3. A Settled Matter: Arkansas began receiving its share of opioid litigation settlement proceeds, a total award of more than $200 million shared between the state, counties and municipalities. The Arkansas attorney general directed more than $140 million to the state’s general revenue fund to be allocated by the General Assembly, while the counties and municipalities formed a joint venture, the Arkansas Opioid Recovery Partnership, to oversee the strategic disbursement of opioid settlement funds.
4. An All-Around Approval: Federal officials approved the state’s plan to offer care coordination and community-based services to address health-related socials needs through the Life360 program. The Life360 program targets at-risk pregnant women and others and is expected to fully launch in 2023.
5. A Major Decision: Following the leak of a draft opinion, the U.S. Supreme Court issued its decision in Dobbs v. Jackson Women’s Health Organization, which ended constitutional abortion protections and triggered state laws prohibiting abortion, including Arkansas’ own, which prohibits abortion except to save the life of a pregnant woman in a medical emergency.
6. A Welcome Reopening: With the assistance of a sales tax approved by county voters and the infusion of more than $6 million in federal recovery funds from the state, Sevier County saw the reopening of its hospital, nearly three years after the De Queen Medical Center closed in 2019.
7. A Reason to Smile: Lyon College announced plans to establish a dental school in Little Rock as part of the Lyon College Institute of Health Sciences, which will also house a veterinary school. The dental school expects to welcome its first students in the fall of 2024. The dental professional degree program was approved by regional accreditors in November, and the school expects to see its first students in the fall of 2024.
8. A Surprising Act: Protections for Arkansans under the federal No Surprises Act became effective. The legislation bans surprise billing from out-of-network providers for most emergency services.
9. A True Lifeline: In July, the national suicide prevention hotline number changed to 988. For those in crisis, a simple text or call to 988 will result in connection to trained counselors who will listen and provide support. Arkansas recorded 619 suicides in 2021, up from 583 in 2020.

Let’s briefly turn to 2023. Here are several things to keep your eyes on:

1. With ongoing staffing challenges and inflation pressures, hospitals are in a transition period. Look for legislation to establish state-based requirements for rural emergency hospitals. Even though federal officials have established the new emergency hospital designation, the state has not yet established such a designation, a must for those types of hospitals to be recognized and paid by state Medicaid programs and private payers.
2. Watch for legislation to extend postpartum Medicaid coverage for pregnant women, currently set at 60 days in Arkansas. The recent budget bill passed by Congress made permanent the ability for states to extend postpartum coverage for 12 months. The American Rescue Plan permits 12-month postpartum coverage for up to five years. Thirty-four states and the District of Columbia are offering or planning to offer this option.
3. Speaking of Medicaid, watch for a massive Medicaid eligibility redetermination process to begin in April. Most Medicaid coverage terminations were not permitted during the public health emergency, but the recent federal budget bill permits states to begin their processes for redetermining eligibility for current enrollees in April. Notably, state law requires Medicaid officials to complete this process in six months. There are currently more than one million Medicaid enrollees in Arkansas.

We will continue to face disruption in our health care system and challenges in our personal ability to stay healthy, but here’s to the promise of 2023, hoping that it will bring resilience and innovation in the midst of these pressures.

Editor’s note: Craig Wilson, J.D., M.P.A., is the director of health policy for the Arkansas Center for Health Improvement, an independent, nonpartisan health policy center in Little Rock. The opinions expressed are those of the author.