Category Archives: Pandemic

Why are U.S. nursing homes at high risk for COVID-19 contraction?

Emerging data from around the world suggest that nursing home residents are at exceptionally high risk for contracting COVID-19, with some areas reporting that close to half of regional deaths are either in nursing homes or in hospitals after admission from a nursing home. Less than 0.5% of Americans live in nursing homes, but the remarkable concentration of risk in such facilities may have profound implications on how we handle the pandemic.

In this article, Milliman’s Bruce Pyenson and Harvard’s David Grabowksi discuss why nursing homes have been hit so hard by COVID-19 and what can be done to fight the disease in these facilities.

Understanding the path to COVID-19 vaccination

Vaccinations have historically been shown to boost a person’s immune system, eliminate and prevent the spread of infections, and lessen the burden on the healthcare delivery system. The concept of using vaccines has been around since the 1500s with several accounts describing smallpox inoculation as practiced in India and China.

Vaccines undergo strict testing and research under U.S. Food and Drug Administration (FDA) standards prior to becoming available to the public. Vaccinating populations has helped countries take steps toward wiping out debilitating and deadly infections such as polio and smallpox.

In view of the COVID-19 pandemic, Milliman’s Stephen George has written a new paper focusing on:

  • Examining why, when, and how vaccines are used
  • Highlighting the vaccine development pathway
  • Reviewing previous experience with viral pandemics
  • Assessing ways payers can address COVID-19

Challenges of interpreting data, reports, and media coverage regarding COVID-19

As COVID-19 has spread around the globe, scientists, mathematicians, economists, health professionals, and thinkers of all types have worked within their fields of study to try to quickly understand, analyze, and explain the effects of the global pandemic.

On a daily basis, important and time-sensitive questions are being posed and answered through the popular media, scientific journal articles, and countless other avenues. With the abundance of pandemic-related articles and discussions, it can be difficult to sort through the noise and determine which sources of information can be trusted, what analysis might not stand up to scrutiny, and how to reconcile apparently conflicting findings.

Milliman consultants Pamela Pelizzari, Stoddard Davenport, and Carol Bazell offer some perspective by exploring the challenge of interpreting data, reports, and media coverage surrounding the COVID-19 pandemic in this paper.

How will the coronavirus affect health insurance enrollment?

In the United States, the COVID-19 pandemic has put millions of people out of work. A portion of the newly unemployed and their families are expected to seek health insurance coverage. Some have been furloughed, which allows them to keep their employer-sponsored health insurance while applying for unemployment benefits. Others may be able to find employer-sponsored health insurance coverage with parents or spouses.

Before the Patient Protection and Affordable Care Act (ACA), newly uninsured adults and families could purchase COBRA coverage, individual market plans, or short-term plans, enroll in Medicaid, or participate more fully in federal health options for which they were eligible. Today, newly unemployed adults and their families have the following additional options not available prior to the ACA:

  • Individual market plans through the state or federally run marketplaces with federal premium assistance for qualifying households
  • Expanded Medicaid coverage in 36 states
  • Young adults (under age 26) can enroll in their parents’ employer-sponsored insurance

In this brief, Milliman’s Annie Man and Barbara Dewey discuss the health insurance options available to the newly unemployed and how this may affect the ACA individual market.

COVID-19 and the future cost of coverage in the commercial health insurance market

Although pricing actuaries are trained to project future costs in environments of heightened risk, COVID-19 has introduced unprecedented disruption and uncertainty. The pandemic has affected all aspects of the healthcare industry and the American economy, altering the landscape in ways that may both increase and decrease expected costs. This volatile and uncertain environment also presents an extraordinary challenge for health plans developing rates for 2021 commercial coverage.

This paper by Milliman’s Jeff Milton-Hall, Tom Murawski, and Doug Norris is intended to help commercial health plans navigate this evolving environment. The authors discuss key considerations for how the pandemic and its aftermath could affect the cost of health insurance coverage in 2021.

Health coverage options for the COVID-19 unemployed population

Over a five-week period in March and April, approximately 26 million Americans applied for unemployment benefits. As a result, many have lost their employer-sponsored health coverage. The U.S. healthcare system has never had to reenroll this many people this fast.

Fortunately, individuals facing changes in employment have several options for maintaining health coverage. However, navigating those options can be confusing. Among the options are COBRA, the Children’s Health Insurance Program (CHIP), and the Patient Protection and Affordable Care Act (ACA).

In this article, Milliman’s Les Kartchner and Troy Pritchett outline a road map that newly unemployed Americans may find useful as they sort out their options, offering perspective on potential factors that can be expected at the macro level.