As the medical community sought to increase hospital capacity to serve COVID-19 patients, reduce the spread of COVID-19, and follow social distancing mandates, medical claims volume dropped precipitously. Many patients elected to forego or delay medical care. Colonoscopies, knee and hip replacements have almost disappeared. A May 2020 Kaiser Family Foundation Tracking poll found that nearly half of adults (48%) say they or someone in their household have postponed or skipped medical care due to the coronavirus crisis.

edHEALTH claims data reflect these trends. Pre-COVID, medical spending was running 14% ahead of 2019. During the pandemic, spending is down approximately 40% year over year.

The KFF poll estimates that as stay-at-home restrictions ease, most (68% of those who delayed care, or 32% of all adults) expect to get the delayed care in the next three months. However, this timing could change if there’s a resurgence of COVID-19 cases in the fall. Although foregoing care like a sprained ankle or headache will generally not adversely affect one’s health, delaying needed care is costly to the patient and payer. The accompanying KFF chart shows that 22% of the patients who postponed medical care reported that their condition got worse.

Milliman, one of the world’s largest providers of actuarial and related products and services, recently released a white paper that analyzes the impact of COVID-19 on US healthcare costs. Of note, Milliman states that the cost of services deferred to 2021 and beyond could be significant.

“Depending on whether and when there is a resurgence in COVID19 will dictate when claims increase rapidly – either in the last half of 2020, or in 2021,” said Steven Keshner, Senior Vice-President and Chief Actuary for Spring Consulting Group, LLC. We will continue to keep you apprised about this rapidly changing landscape.