ABSTRACT
Coronavirus disease-2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), has abruptly transformed the outlook of employer health benefits plans for 2020 and 2021. Containing the spread of the virus and facilitating care of those infected have quickly emerged as immediate priorities. Employers have adjusted health benefits coverage to make COVID-19 testing and treatment accessible and remove barriers to care in order to facilitate the containment of the disease. Employers also are introducing strategies focused on testing, surveillance, workplace modifications, and hygiene to keep workforces healthy and workplaces safe. This paper is intended to provide evidence-based perspectives for self-insured employers for managing population health during the COVID-19 pandemic. Such considerations include (1) return to work practices focused on mitigating the spread of COVID-19 through safety practices, testing and surveillance; and (2) anticipating the impact of COVID-19 on health benefits and costs (including adaptations in delivery of care, social and behavioral health needs, and managing interrupted care for chronic conditions).
Subject(s)
COVID-19 , Occupational Health , Pandemics , Population Health , Return to Work , COVID-19/diagnosis , COVID-19/economics , COVID-19/prevention & control , COVID-19/therapy , Health Benefit Plans, Employee/economics , Health Care Costs , Humans , Physical Distancing , SARS-CoV-2Subject(s)
Insurance Coverage/economics , Insurance, Health/economics , Medicaid/economics , Patient Protection and Affordable Care Act/trends , Unemployment , Child , Health Benefit Plans, Employee/economics , Health Benefit Plans, Employee/trends , Humans , Insurance Coverage/trends , Insurance, Health/trends , Medicaid/trends , Patient Protection and Affordable Care Act/economics , Unemployment/trends , United States/epidemiologySubject(s)
Health Benefit Plans, Employee/legislation & jurisprudence , Health Care Reform/methods , Patient Protection and Affordable Care Act , Universal Health Insurance , Health Benefit Plans, Employee/economics , Health Care Reform/legislation & jurisprudence , Insurance Coverage , Patient Protection and Affordable Care Act/legislation & jurisprudence , Taxes/legislation & jurisprudence , United StatesABSTRACT
INTRODUCTION: This study aims to quantify out-of-pocket spending associated with respiratory hospitalizations for conditions similar to those caused by coronavirus disease 2019 and to compare out-of-pocket spending differences among those enrolled in consumer-directed health plans and in traditional, low-deductible plans. METHODS: This study used deidentified administrative claims from the OptumLabs Data Warehouse (January 1, 2016-August 31, 2019) to identify patients with a respiratory hospitalization. It compared unadjusted out-of-pocket spending among consumer-directed health plan enrollees with that among traditional plan enrollees using difference of mean significance tests and repeated the analysis separately by age category and calendar year quarter. These data were collected on a rolling basis by OptumLabs and were analyzed in March 2020. RESULTS: Commercially insured consumer-directed health plan enrollees had significantly higher out-of-pocket spending than traditional plan enrollees, and these differences were largest among younger populations. The largest difference in out-of-pocket spending occurred during the first half of the year. CONCLUSIONS: Consumer-directed health plan enrollees may experience differential financial burden from a hospitalization related to coronavirus disease 2019. Although some insurers are waiving cost-sharing payments for coronavirus disease 2019 treatment, self-insured employers remain exempt. As of now, policy responses may be insufficient to reduce the financial burden on consumer-directed health plans enrollees with respiratory hospitalizations related to coronavirus disease 2019.