Diagnoses on the rise as U.S. employers see sharp medical spend increases
As COVID-19 cases continue gripping the country, skyrocketing medical costs as a result of long COVID pose a significant financial risk not just for patients, but also for buyers of care in the public and private sectors. According to results of the new monthly “Nomi Trends in Spend Tracker,” announced today by nationwide direct healthcare company Nomi Health, long COVID cost employers an average $600 more per member than the average diabetes episode in the first half of 2022.
“While we'd all love to put this pandemic behind us, employers can see the potentially devastating effects of long COVID and its undeniable impact on healthcare costs and workforce stability,” Mark Newman, founder and CEO of Nomi Health, said. “Costs will continue to rise. Employers need to act now to support their employees with symptom awareness and care guidance while streamlining medical spending. It’s critical they plan ahead, and Nomi Health is filling the urgent need for more efficient healthcare delivery and cost management to combat these risks.”
Nomi Health reviewed more than 20 million medical claims between January and June 2022 to identify claims for patients with diabetes and those diagnosed with long COVID — any of more than two dozen symptoms that linger, recur or first appear at least one month after a COVID-19 infection. When examining long COVID and its associated conditions — breathing abnormalities, malaise and fatigue, cough, throat and chest pain, and respiratory failure — researchers found per-member employer spend was on average $2,654.67, which is more than 26% higher than the average diabetic spend.
Beyond that, when comparing baseline COVID claims to long COVID claims for thousands of members, the “Nomi Trends in Spend Tracker” uncovered other sharp increases for employers and patients:
- 203% increase in medical spending per-member per-month within the first six months following initial COVID-19 diagnosis, resulting in a predicted $9,000 per case increase in medical spending compared to similar patients who had COVID but no subsequent symptoms of long COVID
- 421% increase in inpatient hospital spend within the first six months following initial COVID-19 diagnosis, resulting in a predicted increase of $6,000 compared to similar patients without long COVID
- 126% increase in costly diagnostic laboratory and imaging procedures
- 110% increase in outpatient visits for patients, resulting in rising actual and opportunity costs
- Likelihood of missing work for medical reasons is 3.6 times higher, resulting in significant time and productivity loss for both patients and employers, exposing all parties to business and financial risk
- Average predicted cost of long COVID to patients is nearly $9,500 within the first six months following COVID diagnosis, driven by doctor’s visits, hospital stays and an increased likelihood of prescriptions for steroids, antibiotics, respiratory medications and more
This is the first study in the monthly “Nomi Trends in Spend Tracker” series, which will investigate costs associated with different health care topics. The retrospective cohort study was conducted by Artemis, a leading benefits analytics platform acquired by Nomi Health in January 2022.
Nomi Health, which makes it easier than ever to access the highest quality affordable care nationwide, has been a leader on the frontlines of the pandemic, delivering COVID testing and care to 15 million Americans in hundreds of communities across the U.S., many of which are underserved or rural. Nomi Health works directly with buyers of healthcare to lower expenses, designing a care delivery system that maximizes efficiency and lowers COVID testing costs by up to 60%. For more information, visit nomihealth.com.
Methodology
This is a retrospective cohort study based on an anonymized, aggregated set of 20.3 million medical claims for over 4.68 million insured members in 2022. The data set identifies 252,561 members with diabetes care episodes and 6,988 members with post COVID syndrome. The average diabetic cost, both medical and pharmacy, per member was compared to the average medical cost of post COVID and closely associated conditions. Using the most up to date data through June 2022. Limitations include COVID incidents not reported through medical claims (at-home, rapid testing) and low incidence of long COVID diagnosis.
About Nomi Health
Nomi Health is a nationwide direct healthcare system making it easier than ever for any buyer of healthcare to access the highest quality affordable care for their communities. The company’s direct care ecosystem is enabled by technology, and encompasses a real-time operating and payment system — inclusive of analytics and payment rails — as well as an integrated care delivery infrastructure featuring essential care services, pharmacy and an open network. To date, Nomi Health has saved buyers of care an average of 30 percent compared to traditional healthcare costs, while enabling them to give their communities more access to lower cost, high quality care.
From rural counties to some of the largest cities in America, Nomi Health has administered everyday healthcare services to more than 14 million Americans and counting in hundreds of communities nationwide. During COVID-19, this direct care model played a pivotal role in care access, public health and keeping economies open and operating.
Based in Orem, Utah, Nomi Health employs more than 2,000 nationwide, working to lower healthcare expenses, widen care access and improve the patient experience. The company is led by an experienced, cross-functional leadership team with clinical, healthcare, technology and finance backgrounds. Nomi Health has so far invested more than $10 million dollars in improving the well-being of the communities it serves. Visit us on Twitter @NomiHealth and www.nomihealth.com.
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Contacts
Maggie Habib
maggie.habib@nomihealth.com
