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The Covid-19 pandemic has disrupted the typical course of most things in our lives. Employers are facing worker shortages, high turnover, Covid prevention measures, employee burnout, impending delayed care costs and much more. Now that we are settling into the ‘new normal’, it is past time to get ‘back to basics’ with regards to getting employees and their families back to preventive and chronic care.

According to the Health Care Cost Institute (HCCI), looking at mid-year 2020 over mid-year 2019 data:

  • In mid-April 2020, overall childhood immunizations were down 60% compared to 2019. This ranged from 75% for Meningococcal and HPV vaccines, to 33% for Rotavirus, and the diphtheria, tetanus toxoids, acellular pertussis family of vaccines. Childhood immunizations declined 18% in 2020 compared to the previous year. 
  • Mammograms and Pap smears were down nearly 80% in April 2020 compared to 2019. However, both services recovered throughout the summer and fall, with Pap smears and mammograms rebounding above 2019 levels in August and November.
  • As of December 2020, colonoscopies were down about 15% compared to 2019, an improvement over their lowest point in mid-April 2020 where they were down almost 90%. Overall, the number of colonoscopies in 2020 declined by 25% from 2019.

The trend continues into 2021. Key facts released from the World Health Organization show that in 2021, there were only 25 vaccine introductions other than COVID-19 vaccine and completely unvaccinated children increased by 5 million. Also, there was a global drop in vaccine coverage from 86% (2019) to 81% (2021). And girls receiving human papillomavirus (HPV) vaccinations fell by 3.5 million, compared to 2019.

While many employers have robust wellness, preventative and chronic care strategies in place, it may be time to study program data to determine if these are still applicable and effective in a post-pandemic world. Things to consider:

  • Are current incentives aligned with current workforce dynamics (Hybrid workforce, access to care, financial barriers to care)
  • Are the benefits easy to understand, and even easier to access?
  • Are communications reaching all family members?
  • Do employees understand it’s ‘safe’ to go back to the doctor?
  • Review basic cost containment programs designed to predict and mitigate high-cost claimants (Patient Management, Utilization Management, Disease Management) and update as necessary.

Finally, employers must consider the ongoing cost impact of delayed care, and what it will mean for future benefit design. There are multiple projections in the market that put healthcare trend between 4%-10% for 2023. The challenge is that many of these models do not contemplate employees coming into the healthcare system with more severe disease due to delayed or avoided care. For some employers, a few high-cost claimants could have catastrophic financial impact. In order to support our membership, IBI will produce research in 2022 on the effects of delayed care.


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