Employers' cost for 'long COVID' exceeds diabetes

“Long COVID” or post-COVID syndrome, has become a significant financial risk for employers, according to new research released by Orem-based direct healthcare company Nomi Health. The report, in the “Nomi Trends in Spend Tracker,” found that long COVID cost employers an average $600 more per member than the average diabetes episode in the first half of 2022. Diabetes is traditionally the most-costly long-term healthcare expense.{mprestriction ids="1,3"}

“While we’d all love to put this pandemic behind us, employers can see the potentially devastating effects of long COVID and its undeniable impact on healthcare costs and workforce stability,” said Mark Newman, founder and CEO of Nomi Health. “Costs will continue to rise. Employers need to act now to support their employees with symptom awareness and care guidance while streamlining medical spending. It’s critical they plan ahead.”

Nomi Health reviewed more than 20 million medical claims between January and June 2022 to identify claims for patients with diabetes and those diagnosed with long COVID — any of more than two dozen symptoms that linger, recur or first appear at least one month after a COVID-19 infection. When examining long COVID and its associated conditions — breathing abnormalities, malaise and fatigue, cough, throat and chest pain and respiratory failure — researchers found the per-member employer spending averaged $2,654.67, which is more than 26 percent higher than the average diabetic spend. Beyond that, when comparing baseline COVID claims to long COVID claims for thousands of members, the tracker uncovered other sharp increases for employers and patients:

• A 203 percent increase in medical spending per-member per-month within the first six months following initial COVID-19 diagnosis, resulting in a predicted $9,000 per case increase in medical spending compared to similar patients who had COVID but no subsequent symptoms of long COVID.

• A 421 percent increase in inpatient hospital spend within the first six months following initial COVID-19 diagnosis, resulting in a predicted increase of $6,000 compared to similar patients without long COVID.

• A 126 percent increase in diagnostic laboratory and imaging procedures.

• A 110 percent increase in outpatient visits for patients, resulting in rising actual and opportunity costs.

• The likelihood of missing work for medical reasons is 3.6 times higher, resulting in significant time and productivity loss for both patients and employers, exposing all parties to business and financial risk.

• The average predicted cost of long COVID to patients is nearly $9,500 within the first six months following COVID diagnosis, driven by doctor’s visits, hospital stays and an increased likelihood of prescriptions for steroids, antibiotics, respiratory medications and more.

This is the first study in the monthly “Nomi Trends in Spend Tracker” series, which will investigate costs associated with different healthcare topics. The retrospective cohort study was conducted by Artemis, a benefits analytics platform acquired by Nomi Health in January.

This is a retrospective cohort study based on an anonymized, aggregated set of 20.3 million medical claims for over 4.68 million insured members in 2022. The data set identifies 252,561 members with diabetes care episodes and 6,988 members with post-COVID syndrome. The average diabetic cost, both medical and pharmacy, per member was compared to the average medical cost of post-COVID and closely associated conditions.{/mprestriction}