EXL Health Analysis Charts Long-Term Impact of COVID-19 on Health Plans and Providers
“The healthcare industry is facing a strong set of headwinds as we start the slow climb out of the COVID-19 pandemic,” said
Drawing on several
- 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.
- Projected 18% Increase in Future Avoidable Spend: The combined effect of delayed care, increase in gaps and social barriers can potentially lead to increases in future avoidable spend for populations. In our sample commercial population, we project the potential for this avoidable future spend across ED visits, inpatient visits and readmissions to increase by roughly 18%.
In addition to the analysis of COVID-19 headwinds, the paper also outlines a playbook for the healthcare industry to navigate these challenges, including the development of patient education and assistance tools, the use of AI to flag at-risk patients for vaccine prioritization, handle social disparities and ongoing patient tracking and care management. The full paper can be accessed here.
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