How Covid-19 will continue to impact payer mix

When peak shifts to Medicaid, the individual market, and the uninsured are expected to occur

The Covid-19 pandemic has sparked unprecedented rates of job loss. Unemployment has swung from 3.5% in Dec 2019 (the lowest rate on record since 1969) to a high of 14.7% in April 2020 (the highest rate on record since the Great Depression).

While it would reasonable to assume that record unemployment levels might lead to significant declines in employer-sponsored coverage—and substantial increases in Medicaid unenrollment and uninsurance—plans and providers in many markets have told us that they have experienced only modest shifts to-date. Some providers have even reported increases in commercial payer mix as younger patients with employer-sponsored coverage have returned for elective procedures at higher rates than those with public coverage.

The slower-than-expected shift is likely due to a variety of factors. The industries that have been hit hardest by the pandemic—such as the service industry—were less likely to provide health benefits. Many of the newly unemployed have also been able to maintain employer-sponsored coverage, whether through COBRA, by attaining coverage through a spouse, or because they were furloughed rather than laid off.

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