Coronavirus: Insurance companies may see huge costs, report says

April 14, 2020

Costs could reach as high as $556 billion between 2020 and 2021.

The COVID-19 coronavirus pandemic could cost insurance companies huge sums of money, according to a report from American Health Insurance Plans.

The report projects costs of between $56 billion and $556 billion between 2020 and 2021 depending on an infection rate between 10 percent and 60 percent. Of those sums, between $10 billion and $78 billion would be made up of enrollee cost sharing. While these numbers represent the two extremes of infection rates, the report takes a 20 percent infection rate as a baseline which would see costs of between $112.5 billion and $185.4 billion, with between $20 billion and $26 billion in cost sharing.

Based on that 20 percent baseline infection with a low hospitalization rate, the report estimates that more than 51 million Americans would be infected with 5.5 million being hospitalized due to the disease and 1.3 million being treated in intensive care units.

For the hospitalized patients, the report estimates costs of $11,050 for those not treated in intensive care units and $30,950 for those who are. The average outpatient cost is estimated at $850 per patient and professional services cost is estimated at $130.

These amounts were based on historical costs for conditions that may represent a similar expense profile, the report says.

The authors of the report acknowledged a number of limitations in their analysis including:

·      High risk conditions – Patients with a high risk condition like obesity, heart disease, or severe asthma, are more at risk for severe complications

·      Forgoing of care – Social distancing, hospital capacity, and state guidelines may cause some patients to delay seeking care

·      Out of network costs and cost sharing – If patients receive treatment out of their network, prices could be significantly higher

·      Price changes – Due to the use of historical cost data, the analysis does not include provisions for changes in price due to the pandemic

According to the World Health Organization, as of April 14, more than 1.8 million people have been infected with COVID-19 coronavirus and more than 117,000 people have died. The U.S. currently has the highest number of confirmed cases with 553,882.

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