Implications of Early Health Care Spending Reductions for Expected Spending as the COVID-19 Pandemic Evolves.
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ABSTRACT:
SUBMITTER: McWilliams JM
PROVIDER: S-EPMC7653535 | biostudies-literature | 2021 Jan
REPOSITORIES: biostudies-literature
Publications
Implications of Early Health Care Spending Reductions for Expected Spending as the COVID-19 Pandemic Evolves.
McWilliams J Michael JM Russo Ali A Mehrotra Ateev A
JAMA internal medicine 20210101 1
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Project description:Background:The coronavirus disease 2019 (COVID-19) pandemic has increased burden on healthcare systems with subsequent reductions in non-emergent hospitalizations and procedures. While there are widespread reports of intentional reductions in elective hospitalizations, trends in urgent or emergent hospitalizations including heart failure (HF) hospitalizations have not been adequately characterized. Methods:We evaluated trends of HF hospitalizations before and during the COVID-19 pandemic at the University of Mississippi Medical Center using electronic health records and discharge database. We also compared HF hospitalization trends during the same time frame in 2019 to account for seasonal variation in HF presentations. Results:Prior to the COVID-19 pandemic in our medical center, a mean of 30 patients per week were admitted with a principal diagnosis of HF. After the first case of COVID-19 was diagnosed in Mississippi, there was a sharp 50% decline in the number of HF hospitalizations that declined even further after a "state of emergency" was declared in Mississippi. Conclusions:Based on observations from a large academic medical center, there has been a significant reduction in the number of patients hospitalized for HF during the COVID-19 pandemic. Further investigation of these trends is warranted to determine the effects of the COVID-19 pandemic on long-term HF outcomes.
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Project description:ObjectivesTo estimate excess health care costs in the 12 months following COVID-19 diagnosis.Study designRetrospective cohort study using Blue Cross Blue Shield of Rhode Island claims incurred from January 1, 2019, to March 31, 2022, among commercial and Medicare Advantage members.MethodsDifference-in-differences analyses were used to compare changes in health care spend between the 12 months before (baseline period) and the 12 months after (post period) COVID-19 diagnosis for COVID-19 cases and contemporaneous matched controls without COVID-19.ResultsOverall, there were 7224 commercial and 1630 Medicare Advantage members with a COVID-19 diagnosis on/before March 31, 2021, each with a matched control, yielding a sample of 14,448 commercial and 3260 Medicare Advantage members. Among commercial members, 51.9% were aged 25 to 54 years and 54.0% were female. Among Medicare Advantage members, 94.2% were 65 years or older and 62.0% were female. Among commercial members, from the baseline period to the post period, total health care spend increased $41.61 (7.7%) per member per month (PMPM) more among COVID-19 cases compared with their matched controls. Among Medicare Advantage members, the difference-in-differences was greater, with spend increasing $97.30 (13.1%) PMPM more among cases compared with controls. The difference-in-differences was greatest for outpatient and professional services (both populations) and prescription services (Medicare Advantage only).ConclusionsCOVID-19 diagnosis was associated with excess health care spend PMPM over the subsequent 12 months, highlighting the importance of societal preparations to support individuals' long-term health care needs following COVID-19 and as a part of future pandemic preparedness.
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