Do thermistors degrade in accuracy without hard failure? Lately I've been having problems with overhangs not adhering when curvature is outward (stringing across instead) that look like what you'd see at insufficient temperature, and that go away with temperature jacked up a bit (PLA at 220°C, which is a bit extreme) or fan disabled. Is it possible that the hotend thermistor has drifted and is no longer accurate, making the actual temperature lower than nominal? Or do these things fail hard when they fail?
Yes, thermistors can drift in value as well as outright failing (usually open).
In my experience this is not uncommon in thermistors operated above 100 degrees C. The drift is typically downward in resistance so the controlled temperature will be less than the desired setpoint, which is exactly what you are observing.