Planning for the Post-COVID Syndrome: How Payers Can Mitigate Long-Term Complications of the Pandemic
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and Rozalina G. McCoy, M.D., M.S.1,2
1
Department of Health Sciences Research, Division of Health Care Policy & Research, Mayo Clinic, Rochester, MN, USA; 2Department of Internal Medicine, Division of Community Internal Medicine, Mayo Clinic, Rochester, MN, USA.
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 postCOVID-19 complications to quell their clinical, economic, and public health consequences and to support patients experiencing delayed morbidity and disability as a result. KEY WORDS: COVID-19; access to care; uninsured; underinsured; costsharing. J Gen Intern Med DOI: 10.1007/s11606-020-06042-3 © Society of General Internal Medicine 2020
INTRODUCTION
As the COVID-19 pandemic continues to plague the USA, public and private payers have stepped up to alleviate some of the financial stresses on patients and the health care system. Recognizing that widespread and timely testing is critical to curbing the scope and impact of COVID-19, and cognizant of cost-related barriers to testing that patients are likely to experience, the Families First Coronavirus Response Act (FFCRA), passed on March 18, 2020, mandated group health plans and health insurers offering group or individual health policies to provide testing for COVID-19 without any costsharing by the patient. FFCRA also allocated funding to allow COVID-19 testing to be provided at no cost for those on public health insurance programs, such as Medicare and Medicaid. Medicare and most private insurance companies went further to also waive cost-sharing for the treatment of COVID-19.1 Received May 1, 2020 Accepted July 7, 2020
However, as most patients with COVID-19 infection ultimately survive, clinicians and policymakers cannot lose sight of the potential long-term consequences of COVID-19 on patient health and economic stability. With 640,198 COVID-19 survivors in the USA as of June 23, 2020, and a total of 2,328,562 known cases to date,2 we must anticipate and plan for the personal and financial tolls of near- and long-term sequelae of COVID-19 and its treatments, while simultaneously taking proactive steps to minimize these risks.
POTENTIAL LONG-TERM COMPLICATIONS of COVID-19 For patients diagnosed with COVID-19, surviving the disease may
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