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Implications of Early Health Care Spending Reductions for Expected Spending as the COVID-19 Pandemic Evolves

Educational Objective
To identify the key insights or developments described in this article
1 Credit CME

The effect of the coronavirus disease 2019 (COVID-19) pandemic on health care spending in the US has important implications for payers, clinicians, hospitals, health care systems, and patients, and has been the subject of much debate. Understanding how early spending changes varied by disease incidence and implementation of policies to limit transmission can inform expectations about health care spending as the pandemic evolves.

For the first 14 weeks of 2020, we analyzed multipayer deidentified claims from FAIR Health spanning roughly 75% of the commercially insured and 50% of the Medicare Advantage population. Our analysis included fee-for-service (not capitated) claims submitted to FAIR Health by June 25, 2020, and used 2019 data to correct for unreported claims (eAppendix in the Supplement). The study was determined not to be human subjects research and thus not reviewed by the Harvard Medical School Committee on Human Studies.

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Article Information

Accepted for Publication: August 14, 2020.

Corresponding Author: J. Michael McWilliams, MD, PhD, Department of Health Care Policy, Harvard Medical School, 180 Longwood Ave., Boston, MA 02115 (mcwilliams@hcp.med.harvard.edu).

Published Online: November 9, 2020. doi:10.1001/jamainternmed.2020.5333

Author Contributions: Dr McWilliams and Ms Russo had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: All authors.

Acquisition, analysis, or interpretation of data: All authors.

Drafting of the manuscript: McWilliams, Russo.

Critical revision of the manuscript for important intellectual content: All authors.

Statistical analysis: McWilliams, Russo.

Administrative, technical, or material support: Mehrotra.

Supervision: McWilliams.

Conflict of Interest Disclosures: Dr McWilliams reports serving as a paid member of the Academic Advisory Board for FAIR Health. No other conflicts were reported.

Disclaimer: The conclusions reached reflect the interpretation of the authors alone and do not necessarily reflect the views of FAIR Health, Inc.

Additional Contributions: We thank David Cheng, MS, Josh Smolinsky, MS, and Eric Okurowski, MBA, of FAIR Health, Inc, for conducting the data analysis, providing claims expertise, and constructing data visualizations. They were not compensated.

References
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