Coronavirus Update – 4-27-20

As a new week begins it is clear that the general focus is shifting from flattening the curve to transitioning into a new normal with significantly increased economic activity.  My update today has a number of items related on looking forward to the new normal:
Milliman Actuarial Study
Milliman, a leading international actuarial firm, has released a white paper outlining their take on the impacts of the coronavirus crisis on health care costs in 2020.  Like all of the other projections that have been released previously, there are many caveats included in this analysis due to the number of questions that remain unanswered.  That said, here are the key takeaways: 

  • They ran 18 different models, changing many of the variables ranging from the duration of the crisis to the number of individuals infected.  
  • While there is an expected increase in costs associated with testing and treatment for COVID-19, these costs are more than offset by the reduction in costs related to delayed or eliminated treatments.  
  • If the delay in elective procedures ends in June of 2020, the projected cost reduction in 2020 will range from $140 Billion to $375 Billion.  
  • If delayed care is pushed through the end of 2020, the cost reduction ranges from $75 Billion (lower than above due to associated increased spending tied to second wave of COVID-19) to $575 Billion. 
  • As I will outline below, at least in Michigan we expect to see that the claims reduction related to delayed care has bottomed out and claims volume will start to increase again. 
  • Fully Insured groups should be prepared to push back on significant increases at their next renewal. 

Policy Forum Zoom Meeting with Health Care Providers:
I attended a meeting hosted by the West Michigan Policy Forum where we received updates from the leaders of the largest health systems in West Michigan earlier today.  Those on the call included the leaders of Spectrum Health, Metro Hospital (U of M), St. Mary’s (Trinity), Mary Free Bed Rehabilitation, and Pine Rest, and all of them agreed on the following key points:

  • Throughout this crisis they’ve had more non-COVID patients than COVID patients in their facilities. 
  • They’ve continued to perform procedures and provide treatments for cases unrelated to COVID-19. 
  • They want patients that need treatment for their condition to know that they are a safe place to be and have policies in procedures in place to protect them.  
  • They are expecting an increase in non-COVID related cases moving forward and are ramping back up. 

The messages shared today echo those shared with me during our board meeting last week for Holland Hospital as well. 
Pine Rest Study Released:
At noon today Pine Rest released a study outlining their assessment of the looming mental health crisis resulting from the coronavirus crisis.  In short, they are seeing an increase in all of the leading indicators of a mental health crisis and they are advising that a statewide effort is needed to avoid a significant increase in preventable deaths.  As a result, here are a few key steps for you to consider: 

  • Remind your employees about your stand alone Employee Assistance Program or the one through your life insurance carrier. 
  • Here is a link to wallet card for the suicide prevention line that you can distribute to your employees.  
  • One item that Pine Rest is advocating for is the waiving of cost sharing for mental health services through health plans.  While this is a logical recommendation and might make sense for your plan, be sure to evaluate the potential impacts of doing so. 
  • If your health plan is self-funded and you have 14 minutes to spare, I encourage you to watch this video interview of the CEO of eHome Behavioral Care.  Brad Rex ran EPCOT for Disney for 5 years and brings a unique perspective to behavioral health care.  In short eHome is virtual behavioral health care that eliminates the waste that is often associated with this component of health plans. 

eHome Behavioral Health Webinar

https://vimeo.com/aimm/ehome

Password: AIMM1018

Increased Child Care Needs:
As you work to bring employees back to work, you will likely run into a number of employees who have significant child care challenges with schools being closed for the remainder of the year.  Here is a thought that may help you, help them:

  • Consider consulting with your FSA administrator and reviewing your plan document.  You may want to allow employees to make mid year Dependent Care FSA elections due to the following qualifying events: 

Signification Change in Cost

·     A significant change may include any cost change imposed by: 

                                        i.     a dependent care provider who is not a relative of the employee,

                                       ii.      a change in dependent care provider, or (c) a change in the hours of care of the dependent care provider.

Significant Coverage Curtailment

·     Election change may be made if the dependent care provider or hour dependent care hours change.
Miller Johnson Webinar:
Miller Johnson hosted a good session this morning outlining key items to think about in relation to ramping back up. 
As always if there is anything that we can do to help you, please don’t hesitate to ask.