Thursday Miscellany

Photo by Juliane Liebermann on Unsplash

Not without cause, Katie Keith in the Health Affairs blog provides her thoughts on how Biden’s election will impact the Affordable Care Act “in what otherwise appears to be a status quo election.” Compare your thoughts with hers. Remember that the ACA puts a lot authority in the hands of the Secretary of Health and Human Services often together with the Labor and Treasury Secretaries.

On the COVID-19 front, Healthcare Dive reminds us, not surprisingly, that

Patients overwhelmingly turned to telehealth visits early in the COVID-19 pandemic but skipped out on diagnostic procedures and other preventive and elective care that can only be done in-person, according to a study published Thursday [today] in JAMA Network Open. The number of mammograms and colonoscopies performed in March and April dropped more than 65% compared to the year prior, according to the analysis of more than 5 million commercially insured patients. Overall, healthcare utilization dropped 23% in March and 52% in April. * * *

Researchers looked at insurance claims data from 2018 to 2020 from about 200 employers. Beyond major declines for mammograms and colonoscopies, they found other procedures like musculoskeletal surgery, cataract surgery and MRIs all dropped by 45% or more.

In-person visits to manage chronic conditions dropped too, including blood sugar tests for patients with diabetes, which fell more than 50% in March and April. Chemotherapy treatments dropped 4%. And among children under 2 years old, vaccinations dropped 22%.

Utilization did increase in the third quarter. Fierce Healthcare reports that

Major insurer Cigna reported a rebound in healthcare utilization in the third quarter from massive declines in the second quarter due to COVID-19. Cigna, which posted a $1.39 billion profit in the third quarter, said that healthcare use remains slightly below average when not taking into account costs for COVID-19. The insurer’s performance in the quarter was bolstered by its newly rebranded Evernorth subsidiary.  Cigna executives said that utilization was 95% below normal levels without factoring COVID-19 costs. 

Nevertheless, given the current upswing in COVID-19 cases, it’s unlikely that a lot of catch up preventive care will happen this year. It is incumbent on health plans to help members catch up, in the FEHBlog’s opinion.

In sobering news, the Robert Wood Johnson Foundation helps us look at the impact of COVID-19 on households across our country.

Finally, FedWeek offers upcoming Open Season advice to federal employees and annuitants