The COVID-19 pandemic is on track to reach a grim milestone this winter when it will likely become the leading cause of death in the United States. It will do so by surpassing heart disease and cancer, which have historically claimed a combined 4,300 American lives each day from 2015-2020, according to the CDC. Even worse, complications stemming from the virus itself and behavioral factors such as delay and deferral of routine care during the pandemic are giving way to sharp increases in cardiovascular disease, diabetes and mental illness. Meanwhile, vaccine distribution challenges, ranging from a fragmented state-by-state roll-out to social barriers to care are keeping many patients, who should be getting the vaccine, from accessing it. This surge in pandemic-driven knock-on effects is driving runaway increases in healthcare costs and creating care management challenges that have never-before been contemplated.
In order to provide a more detailed accounting of the long-term financial and population health-oriented impacts of the COVID-19 pandemic, we have analyzed for a sample commercial population the average healthcare costs, frequency of chronic conditions, gaps in routine care and social determinants of health over the past two years. We then outlined some of the biggest challenges that health plans, providers and public health officials will need to address in the days and weeks ahead and offer guidance on tools and best practices that can help in that process.
Download the White Paper to learn about how rising costs, new barriers to car and vaccination distribution challenges are creating significant headwinds for health plans and providers, for complete details on this paper’s key insights:
- Monthly Health Insurance Costs Surge and Stay Elevated Following COVID-19 Diagnosis: The average per member per month insurance cost for a sample representative commercial population with no preexisting conditions is $179. That number jumps to and stays elevated, at an average of $470 per month for the next five months post COVID diagnosis month.
- Preexisting Conditions Create A Multiplier Effect for COVID-19-Related Costs: For members with just one preexisting condition, the average per member per month insurance cost starts at $369 and stays elevated, at an average of $624 for the next five months post COVID diagnosis month. For people with two or more preexisting conditions, the average per member per month insurance cost is $1,541 for the five months following a COVID-19 diagnosis.
- Gaps in Routine Care/Screening Set Stage for Increased Chronic Conditions: Preventive screening and routine care declined sharply during 2020 across a wide range of diagnosis codes. Pre-hypertension screening, for example, fell 7.23% and lipid panel testing fell 6.85% in January through October of 2020.
- Vaccine Distribution Faces Logistical and Socioeconomic Hurdles: Shipping and cold storage requirements, combined with ever evolving vaccine eligibility rules, decentralized scheduling information and the need for two doses involves significant tracking and patient coordination requirements. Additionally, social barriers to care, are dispersed unevenly throughout the U.S., creating limits for a one-size-fits-all approach to healthcare outreach and engagement.
- Playbook for Managing COVID-19 Headwinds: Health plans, providers and public health officials need to create a multi-pronged strategy for actively communicating and managing the various “ripple effect” costs and outcomes stemming from the COVID-19 pandemic.
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EXL Health combines deep domain expertise with analytic insights and technology-enabled services to transform how care is delivered, managed, and paid. Leveraging Human Ingenuity, we collaborate with our clients to solve complex problems and enhance their performance with nimble, scalable solutions. With data on more than 260 million lives, we work with hundreds of organizations across the healthcare ecosystem. To learn more about EXL Health, visit exlservice.com/health