Unemployment, COVID-19, and Testing Claims

Original story posted on: November 11, 2020

America’s new normal. 

Unemployed, uninsured, unbelievable! The U.S. Bureau of Labor Statistics indicates that 12.6 million Americans are on unemployment rosters around the country; 32.5 percent of the adult population has been jobless for over five months. Of those who are jobless, many remain uninsured. What happens when these individuals are infected with COVID? The answer is simple: the federal government is supposed to cover testing and treatment.

States with the highest uninsured rates are receiving the majority of dollars. How much are we talking about? How does $1.5 billion sound? That’s a pretty penny, though lower than many experts anticipated. QuoteWizard by Lending Tree evaluated data from the U.S. Centers for Disease Control and Prevention (CDC) on claims reimbursement to providers over the course of the pandemic. The study looked at the total funds provided to each state through uninsured claims for testing and treatment. That figure was then divided by the total number of COVID-19 cases for the state, as well as those who are uninsured. Keep in mind that on top of 12.6 million unemployed in the U.S., there are well over ten million cases of the virus, with over 50,000 hospitalizations at present.

States with the highest numbers of uninsured people were among those that received the most funding in COVID-19 reimbursement – in other words, the highest costs per case were associated with states with the highest levels of uninsured individuals. Ten of these states were non-Medicaid expansion states (specifically Texas, North and South Carolina, Georgia, Florida, Tennessee, Kansas, Mississippi, Alabama, and South Dakota). New Jersey sat atop the list, followed by North Carolina, Texas, and Tennessee. While the average cost per case was $142, the rate variation between New Jersey and Tennessee was fascinating:

  • New Jersey had 222,193 cases, with over $46 million for testing claims, while close to $84 million was allocated for treatment claims reimbursement at $586 per case.
  • Tennessee had over 233,000 cases, with roughly $19 million in testing claims and almost $23 million in treatment claims. The cost per case there was $180.
  • For a point of reference, Montana was ranked last: 24,093 cases, $96,000 in testing claims, and $103,000 in treatment claims. The cost per case was…wait for it…$8.

The URL for the list of all states appears on the QuoteWizard site.

I’m unsure what’s more intriguing about these numbers: the variations in treatment and costs per case, or considering how much higher these costs will get? Economic relief packages passed by Congress allocated $176 billion towards reimbursement for hospitals and healthcare facilities.

With the latest COVID wave hitting states with the highest numbers of persons impacted most by the social determinants of health (SDoH), this week’s Monitor Mondays Listeners Survey asked whether there will be sufficient reimbursement by the federal government to pay all submitted claims. The answers may surprise you, and can be viewed here.

Programming Note: Ellen Fink-Samnick is a permanent panelist on Monitor Mondays. Listen to her live reporting every Monday at 10 a.m. EST.

Ellen Fink-Samnick MSW, ACSW, LCSW, CCM, CRP

Ellen Fink-Samnick is an award-winning healthcare industry expert. She is the esteemed author of books, articles, white papers, and knowledge products. A subject matter expert on the Social Determinants of Health, her latest books, The Essential Guide to Interprofessional Ethics for Healthcare Case Management,  Social Determinants of Health: Case Management’s Next Frontier (with Foreword by Dr. Ronald Hirsch), and End of Life Care for Case Management are published through HCPro. She is a panelist on Monitor Mondays, frequent contributor to Talk-Ten-Tuesdays, and member of the Editorial Advisory Boards of Professional Case Management, Case Management Monthly, and RAC Monitor. Ellen also serves as the Lead for Rise Association’s Social Determinants of Health Community.

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