Category Archives: Pandemic

Milliman model analyzes COVID-19 recession and healthcare coverage in the U.S.

The COVID-19 pandemic and the mitigating actions in response by citizens and governments alike have precipitated unprecedented economic disruption in the United States. The second quarter of 2020 marked the largest single-quarter economic contraction in modern U.S. history, driving unemployment rates from historically low levels in February to peaks last seen during the Great Depression.

The unraveling and recovery of the U.S. economy have had and will continue to have a similarly disruptive influence on the enrollment in and composition of U.S. health insurance markets. These impacts will be felt throughout the health system, including in state Medicaid budgets and hospital, physician, and pharmaceutical margins, as well as in the financial performance of commercial and Medicaid health plans.

To understand the interconnected nature of economic changes and health insurance coverage and to project impacts to U.S. health insurance markets, Milliman built a tool referred to as the COVID-19 Advanced Population Shift model. This model combines detailed information on the economic status, health insurance coverage, and health status of each state’s population prior to the COVID-19 pandemic with emerging information on the economic impact of the pandemic response. It allows forecasting the resulting shifts in enrollment and population morbidity across the healthcare markets while providing insight into the key factors driving change. Milliman’s Fritz Busch, Lindsy Kotecki, and Jeff Milton-Hall summarize the findings in this paper.

Critical Point explores telehealth services in the time of COVID-19

The COVID-19 pandemic has dramatically increased the use of telehealth. In this episode of Critical Point, Milliman’s Susan Philip and Mei Kwong, executive director of the Center for Connected Health Policy, talk about what the rise of telehealth could mean for the future of healthcare in the United States. They also discuss what providers, payers, and patients should know about this virtual healthcare service.

To listen to more episodes of Critical Point, click here.

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.