Due to the unprecedented nature of the COVID-19 pandemic, the healthcare landscape in 2020 and 2021 was disrupted at a fundamental level. Certain costs for care, prevention, diagnostics, and lab testing increased unexpectedly, while routine care stopped in 2020 and came roaring back in some segments in 2021.
Here are some statistics to show how COVID-19 has impacted the claims costs1 across Washington and Alaska:
- COVID-19 accounted for about 9% of spending on overall claims paid in December of 2021 and about 5.6% of claims paid in 2021 overall
- Of the money spent on COVID-19 claims, 51.5% accounted for outpatient claims costs. A significant increase from the typical pre-COVID outpatient costs at 33.07% of total spend
- Members who were diagnosed with COVID-19 saw an increase in the amount of PMPM (per member per month) cost immediately post diagnosis, per month:
- 1 year pre-COVID typical cost, $576.59
- 0-3 months past first COVID diagnosis, $1,888.27
- 3-6 months past first COVID diagnosis, $992.03
- 6-12 months past first COVID diagnosis, $787.94
As you can anticipate, the unexpected increase in claims costs has put pressure on rates and we are now experiencing a rate increase in Alaska for 2022. This rate increase contrasts with what we experienced in Alaska in years prior, where the average
premiums in 2021 saw a decrease for the fourth year in a row.
The COVID-19 pandemic as well as the overall landscape of healthcare has sparked everyone to begin thinking about healthcare needs and how members receive care very differently. Our members need access to quality care at a fair price now more than ever. While some members are deferring non-emergent care, many are embracing new options like telemedicine, and Premera has expanded access in many ways to meet this new demand.2
Here are a few examples of how our offerings have changed since the COIVD-19 pandemic began:
- Included access to COVID-19 vaccination, booster, and testing options at no cost to the member
- Expanded our network and began offering more options for video, phone, and text-based care, such as:
- Primary/urgent care
- Mental health care
- Substance use disorder care
- Physical therapy (large groups only)
- Created the Yukon
network (large groups, self-funded and OptiFlex only)
- Introduced the Premier
Provider Program to help members choose quality care
- Provided enhanced digital open
enrollment resources for employers to easily share with their employees in-person or in a virtual working environment
- Launched a new low-cost plan option for impacted groups wanting to maintain coverage (large groups only)
In 2021, we also brought the B’link
employee communications center to Alaska employer groups. On B’link, your employers can find content covering:
- COVID-19 vaccine information
- Welcome materials to get employees started with their benefits
- Open enrollment resources
- Behavioral health care and wellness
- Virtual care options
- Sample communication timelines
- And many more topics covering health plan basics, managing their plan, and accessing care
Encourage your groups to browse through B’link—there are more than a hundred pieces of materials to share. B’link is an employer tool designed to help them assist their employees in understanding and getting the most out of their health plan benefits.
1 - Premera, fully insured group data 2021, claims incurred through 9/30 and paid through 12/31
2- SHRM, https://www.shrm.org/resourcesandtools/hr-topics/benefits/pages/health-plan-cost-increases-return-to-pre-pandemic-levels.aspx