Skip to main content
Top
Published in: Journal of General Internal Medicine 10/2020

01-10-2020 | Care | Perspective

Planning for the Post-COVID Syndrome: How Payers Can Mitigate Long-Term Complications of the Pandemic

Authors: David H. Jiang, B.A., Rozalina G. McCoy, M.D., M.S.

Published in: Journal of General Internal Medicine | Issue 10/2020

Login to get access

Abstract

As the COVID-19 pandemic continues to unfold, payers across the USA have stepped up to alleviate patients’ financial burden by waiving cost-sharing for COVID-19 testing and treatment. However, there has been no substantive discussion of potential long-term effects of COVID-19 on patient health or their financial and policy implications. After recovery, patients remain at risk for lung disease, heart disease, frailty, and mental health disorders. There may also be long-term sequelae of adverse events that develop in the course of COVID-19 and its treatment. These complications are likely to place additional medical, psychological, and economic burdens on all patients, with lower-income individuals, the uninsured and underinsured, and individuals experiencing homelessness being most vulnerable. Thus, there needs to be a comprehensive plan for preventing and managing post-COVID-19 complications to quell their clinical, economic, and public health consequences and to support patients experiencing delayed morbidity and disability as a result.
Literature
2.
go back to reference Dong E, Du H, Gardner L. An interactive web-based dashboard to track COVID-19 in real time. Lancet Infect Dis. 2020. Dong E, Du H, Gardner L. An interactive web-based dashboard to track COVID-19 in real time. Lancet Infect Dis. 2020.
3.
go back to reference Ohtake PJ, Lee AC, Scott JC, et al. Physical Impairments Associated With Post-Intensive Care Syndrome: Systematic Review Based on the World Health Organization’s International Classification of Functioning, Disability and Health Framework. Phys Ther. 2018;98:631-45.CrossRef Ohtake PJ, Lee AC, Scott JC, et al. Physical Impairments Associated With Post-Intensive Care Syndrome: Systematic Review Based on the World Health Organization’s International Classification of Functioning, Disability and Health Framework. Phys Ther. 2018;98:631-45.CrossRef
4.
go back to reference Thompson BT, Chambers RC, Liu KD. Acute Respiratory Distress Syndrome. N Engl J Med. 2017;377:562-72.CrossRef Thompson BT, Chambers RC, Liu KD. Acute Respiratory Distress Syndrome. N Engl J Med. 2017;377:562-72.CrossRef
5.
go back to reference Goyal P, Choi JJ, Pinheiro LC, et al. Clinical Characteristics of Covid-19 in New York City. N Engl J Med. 2020. Goyal P, Choi JJ, Pinheiro LC, et al. Clinical Characteristics of Covid-19 in New York City. N Engl J Med. 2020.
6.
go back to reference Bhatraju PK, Ghassemieh BJ, Nichols M, et al. Covid-19 in Critically Ill Patients in the Seattle Region — Case Series. N Engl J Med. 2020. Bhatraju PK, Ghassemieh BJ, Nichols M, et al. Covid-19 in Critically Ill Patients in the Seattle Region — Case Series. N Engl J Med. 2020.
7.
go back to reference Pandharipande PP, Girard TD, Jackson JC, et al. Long-term cognitive impairment after critical illness. N Engl J Med. 2013;369:1306-16.CrossRef Pandharipande PP, Girard TD, Jackson JC, et al. Long-term cognitive impairment after critical illness. N Engl J Med. 2013;369:1306-16.CrossRef
8.
go back to reference Griffiths J, Hatch RA, Bishop J, et al. An exploration of social and economic outcome and associated health-related quality of life after critical illness in general intensive care unit survivors: a 12-month follow-up study. Crit Care. 2013;17:R100.CrossRef Griffiths J, Hatch RA, Bishop J, et al. An exploration of social and economic outcome and associated health-related quality of life after critical illness in general intensive care unit survivors: a 12-month follow-up study. Crit Care. 2013;17:R100.CrossRef
9.
go back to reference Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395:497-506.CrossRef Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395:497-506.CrossRef
10.
go back to reference Shi S, Qin M, Shen B, et al. Association of Cardiac Injury With Mortality in Hospitalized Patients With COVID-19 in Wuhan, China. JAMA Cardiol. 2020. Shi S, Qin M, Shen B, et al. Association of Cardiac Injury With Mortality in Hospitalized Patients With COVID-19 in Wuhan, China. JAMA Cardiol. 2020.
11.
go back to reference Bangalore S, Sharma A, Slotwiner A, et al. ST-Segment Elevation in Patients with Covid-19 — A Case Series. N Engl J Med. 2020. Bangalore S, Sharma A, Slotwiner A, et al. ST-Segment Elevation in Patients with Covid-19 — A Case Series. N Engl J Med. 2020.
12.
go back to reference Mao L, Jin H, Wang M, et al. Neurologic Manifestations of Hospitalized Patients With Coronavirus Disease 2019 in Wuhan, China. JAMA Neurol. 2020. Mao L, Jin H, Wang M, et al. Neurologic Manifestations of Hospitalized Patients With Coronavirus Disease 2019 in Wuhan, China. JAMA Neurol. 2020.
13.
go back to reference Helms J, Kremer S, Merdji H, et al. Neurologic Features in Severe SARS-CoV-2 Infection. N Engl J Med. 2020. Helms J, Kremer S, Merdji H, et al. Neurologic Features in Severe SARS-CoV-2 Infection. N Engl J Med. 2020.
14.
go back to reference Zhang C, Shi L, Wang F-S. Liver injury in COVID-19: management and challenges. Lancet Gastroenterol Hepatol. 2020;5:428-30.CrossRef Zhang C, Shi L, Wang F-S. Liver injury in COVID-19: management and challenges. Lancet Gastroenterol Hepatol. 2020;5:428-30.CrossRef
15.
go back to reference Corrales-Medina VF, Alvarez KN, Weissfeld LA, et al. Association between hospitalization for pneumonia and subsequent risk of cardiovascular disease. JAMA. 2015;313:264-74.CrossRef Corrales-Medina VF, Alvarez KN, Weissfeld LA, et al. Association between hospitalization for pneumonia and subsequent risk of cardiovascular disease. JAMA. 2015;313:264-74.CrossRef
16.
go back to reference Hatch R, Young D, Barber V, Griffiths J, Harrison DA, Watkinson P. Anxiety, Depression and Post Traumatic Stress Disorder after critical illness: a UK-wide prospective cohort study. Crit Care. 2018;22:310.CrossRef Hatch R, Young D, Barber V, Griffiths J, Harrison DA, Watkinson P. Anxiety, Depression and Post Traumatic Stress Disorder after critical illness: a UK-wide prospective cohort study. Crit Care. 2018;22:310.CrossRef
17.
go back to reference Lee AM, Wong JG, McAlonan GM, et al. Stress and Psychological Distress among SARS Survivors 1 Year after the Outbreak. Can J Psychiatry. 2007;52:233-40.CrossRef Lee AM, Wong JG, McAlonan GM, et al. Stress and Psychological Distress among SARS Survivors 1 Year after the Outbreak. Can J Psychiatry. 2007;52:233-40.CrossRef
18.
go back to reference Devine H, Quasim T, McPeake J, Shaw M, McCallum L, Mactavish P. Chronic pain in intensive care unit survivors: incidence, characteristics and side-effects up to one-year post-discharge. J Rehabil Med. 2019;51:451-5.PubMed Devine H, Quasim T, McPeake J, Shaw M, McCallum L, Mactavish P. Chronic pain in intensive care unit survivors: incidence, characteristics and side-effects up to one-year post-discharge. J Rehabil Med. 2019;51:451-5.PubMed
20.
go back to reference Artiga S, Orgera K, Pham O, Corallo B. Growing Data Underscore that Communities of Color are Being Harder Hit by COVID-19: The Kaiser Family Foundation; 2020. Artiga S, Orgera K, Pham O, Corallo B. Growing Data Underscore that Communities of Color are Being Harder Hit by COVID-19: The Kaiser Family Foundation; 2020.
21.
go back to reference Koma W, Neuman T, Claxton G, Rae M, Kates J, Michaud J. How Many Adults Are at Risk of Serious Illness If Infected with Coronavirus? Updated Data: Kaiser Family Foundation; 2020. Koma W, Neuman T, Claxton G, Rae M, Kates J, Michaud J. How Many Adults Are at Risk of Serious Illness If Infected with Coronavirus? Updated Data: Kaiser Family Foundation; 2020.
22.
go back to reference Turret E, Gluck AR, Beckman AL, et al. The Families First Coronavirus Response Act Is Necessary But Not Sufficient — Here’s What Congress Should Do Next. Health Affairs Blog. 2020. Turret E, Gluck AR, Beckman AL, et al. The Families First Coronavirus Response Act Is Necessary But Not Sufficient — Here’s What Congress Should Do Next. Health Affairs Blog. 2020.
23.
go back to reference Claxton G, Rae M, Damico A, Young G, McDermott D. Employer Health Benefits: 2019 Annual Survey: Henry J. Kaiser Family Foundation; 2019. Claxton G, Rae M, Damico A, Young G, McDermott D. Employer Health Benefits: 2019 Annual Survey: Henry J. Kaiser Family Foundation; 2019.
24.
go back to reference Health Insurance Coverage of the Total Population. In: Foundation KF, ed. State Health Facts. Online; 2018. Health Insurance Coverage of the Total Population. In: Foundation KF, ed. State Health Facts. Online; 2018.
25.
go back to reference According to the Kaiser Family Foundation, there were 157,299,500 Americans who are covered by employer-sponsered health plans. Of which 30% were HDHP. According to the Kaiser Family Foundation, there were 157,299,500 Americans who are covered by employer-sponsered health plans. Of which 30% were HDHP.
26.
go back to reference Agarwal R, Mazurenko O, Menachemi N. High-Deductible Health Plans Reduce Health Care Cost And Utilization, Including Use Of Needed Preventive Services. Health Aff (Millwood). 2017;36:1762-8.CrossRef Agarwal R, Mazurenko O, Menachemi N. High-Deductible Health Plans Reduce Health Care Cost And Utilization, Including Use Of Needed Preventive Services. Health Aff (Millwood). 2017;36:1762-8.CrossRef
27.
go back to reference Wharam JF, Zhang F, Lu CY, et al. Breast Cancer Diagnosis and Treatment After High-Deductible Insurance Enrollment. J Clin Oncol. 2018;36:1121-7.CrossRef Wharam JF, Zhang F, Lu CY, et al. Breast Cancer Diagnosis and Treatment After High-Deductible Insurance Enrollment. J Clin Oncol. 2018;36:1121-7.CrossRef
28.
go back to reference Wharam JF, Galbraith AA, Kleinman KP, Soumerai SB, Ross-Degnan D, Landon BE. Cancer screening before and after switching to a high-deductible health plan. Ann Intern Med. 2008;148:647-55.CrossRef Wharam JF, Galbraith AA, Kleinman KP, Soumerai SB, Ross-Degnan D, Landon BE. Cancer screening before and after switching to a high-deductible health plan. Ann Intern Med. 2008;148:647-55.CrossRef
29.
go back to reference Pollack CE, Mallya G, Polsky D. The impact of consumer-directed health plans and patient socioeconomic status on physician recommendations for colorectal cancer screening. J Gen Intern Med 2008;23:1595-601.CrossRef Pollack CE, Mallya G, Polsky D. The impact of consumer-directed health plans and patient socioeconomic status on physician recommendations for colorectal cancer screening. J Gen Intern Med 2008;23:1595-601.CrossRef
30.
go back to reference Fendrick AM, Buxbaum JD, Tang Y, et al. Association Between Switching to a High-Deductible Health Plan and Discontinuation of Type 2 Diabetes Treatment. JAMA Netw. 2019;2:e1914372.CrossRef Fendrick AM, Buxbaum JD, Tang Y, et al. Association Between Switching to a High-Deductible Health Plan and Discontinuation of Type 2 Diabetes Treatment. JAMA Netw. 2019;2:e1914372.CrossRef
31.
go back to reference Page KR, Venkataramani M, Beyrer C, Polk S. Undocumented U.S. Immigrants and Covid-19. N Engl J Med. 2020. Page KR, Venkataramani M, Beyrer C, Polk S. Undocumented U.S. Immigrants and Covid-19. N Engl J Med. 2020.
32.
go back to reference Garfield R, Orgera K, Damico A. The Coverage Gap: Uninsured Poor Adults in States that Do Not Expand Medicaid: Kaiser Family Foundation; 2020. Garfield R, Orgera K, Damico A. The Coverage Gap: Uninsured Poor Adults in States that Do Not Expand Medicaid: Kaiser Family Foundation; 2020.
33.
go back to reference Lyon SM, Douglas IS, Cooke CR. Medicaid expansion under the Affordable Care Act. Implications for insurance-related disparities in pulmonary, critical care, and sleep. Ann Am Thorac Soc. 2014;11:661-7.CrossRef Lyon SM, Douglas IS, Cooke CR. Medicaid expansion under the Affordable Care Act. Implications for insurance-related disparities in pulmonary, critical care, and sleep. Ann Am Thorac Soc. 2014;11:661-7.CrossRef
34.
go back to reference Guth M, Garfield R, Rudowitz R. The Effects of Medicaid Expansion under the ACA: Updated Findings from a Literature Review: Kaiser Family Foundation; 2020. Guth M, Garfield R, Rudowitz R. The Effects of Medicaid Expansion under the ACA: Updated Findings from a Literature Review: Kaiser Family Foundation; 2020.
35.
go back to reference Koerth M, Bronner L, Mithani J. Why It’s So Freaking Hard To Make A Good COVID-19 Model. FiveThirtyEight. 2020;31:2020. Koerth M, Bronner L, Mithani J. Why It’s So Freaking Hard To Make A Good COVID-19 Model. FiveThirtyEight. 2020;31:2020.
36.
go back to reference Harmon A. Why We Don’t Know the True Death Rate for COVID-19. The New York Times. 2020. Harmon A. Why We Don’t Know the True Death Rate for COVID-19. The New York Times. 2020.
37.
go back to reference Prakash N, Hall E. Doctors and Nurses Say More People Are Dying Of COVID-19 In The US Than We Know. BuzzFeed News. 2020;25:2020. Prakash N, Hall E. Doctors and Nurses Say More People Are Dying Of COVID-19 In The US Than We Know. BuzzFeed News. 2020;25:2020.
38.
go back to reference Westneat D. Coronavirus survival comes with $1.1 million, 181-page price tag. The Seattle Times 2020 June 12, 2020. Westneat D. Coronavirus survival comes with $1.1 million, 181-page price tag. The Seattle Times 2020 June 12, 2020.
39.
go back to reference Coronavirus Aid, Relief, and Economic Security Act. United States; 2020. Coronavirus Aid, Relief, and Economic Security Act. United States; 2020.
Metadata
Title
Planning for the Post-COVID Syndrome: How Payers Can Mitigate Long-Term Complications of the Pandemic
Authors
David H. Jiang, B.A.
Rozalina G. McCoy, M.D., M.S.
Publication date
01-10-2020
Publisher
Springer International Publishing
Published in
Journal of General Internal Medicine / Issue 10/2020
Print ISSN: 0884-8734
Electronic ISSN: 1525-1497
DOI
https://doi.org/10.1007/s11606-020-06042-3

Other articles of this Issue 10/2020

Journal of General Internal Medicine 10/2020 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine