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MHA Today | July 30, 2021



MHA Today

MHA Today is provided as a service to members of the Missouri Hospital Association.

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In April, a prescient column in The Atlantic explored the challenge of COVID-19 long-haulers from a relevant, if not particularly politic, angle — cost. Billions, or perhaps trillions of dollars, have poured into the health care system from the federal treasury to buttress acute care during the crisis. However, we’re just beginning to get a glimpse of what the health effects of the disease are in the long term.

A growing body of evidence suggests that some individuals will continue to suffer physical or mental health conditions beyond the acute phase of COVID-19. The syndrome, which can vary widely, is known as “long COVID” and the sufferers are often called “COVID long-haulers.” It is too early to know whether these individuals will suffer from long-term chronic conditions or whether they will resolve. Studies suggest that even asymptomatic individuals can have long-term damage. The implications are huge for our health care system.

The Atlantic article relied on a study from the Kaiser Family Foundation that projected the “cost of treating just COVID-19 cases for the uninsured would range from $13.9 billion to $41.8 billion.” These costs were based on 2% to 7% of the uninsured population requiring hospitalization. That’s a huge cost to the health care system for a small segment of the population. And, that is the acute care treatment cost.

In Missouri, 11% of the population are uninsured. More than 1 million Missourians are presently eligible for Medicaid — a number that will grow with expansion — and 1.2 million are enrolled in Medicare. The balance have insurance through their employer or purchase coverage independently.

The short-term costs of caring for the uninsured will be offset, at least in part, by federal COVID-19 spending. In the long term, the cost of the pandemic results in significant uncompensated care costs, increased spending in Medicare and Medicaid, and higher premiums for commercial insurance. Assuming again that these are chronic conditions, managing them throughout a patient’s lifetime — especially if they are conditions that require hospitalization — will be very expensive.

There’s little to be done to change the health status of individuals who contracted COVID-19 before vaccines were available. Early evidence suggests that vaccines may help reduce some of the acute challenges of long COVID.  Unfortunately, even asymptomatic cases can end up with long-COVID health issues, according to very early research. This may signal damage that could result in chronic health conditions.

Vaccination, and avoiding the infection entirely, are the best options for maintaining health. Unfortunately, Missouri has one of the lowest vaccination rates in the nation and recent spikes in positive cases and hospitalizations could result in Missouri being overrepresented among COVID-19 long-haulers nationwide.

Earlier this week, President Biden announced that he would support efforts to protect Americans suffering from the long-term effects of the illness from discrimination. Federal agencies have started to release guidance for inclusion of COVID-19 protections in the Americans with Disabilities Act. This could result in costs to both the health care system and the larger safety-net.

On the front lines, hospitals continue to see the significant toll in COVID-19 mortality. Talking about costs may be unseemly when patients are being hospitalized at record levels in some Missouri communities and the COVID-19 death toll continues. However, for those who can’t recognize the value of a shot in their arm, they may understand one to their wallet.

We know that vaccination is the way out of the pandemic. The faster we get there, the lower the costs in lives and treasure.

Let me know what you’re thinking.

Herb Kuhn, MHA President & CEO



Herb B. Kuhn
MHA President and CEO

P.S. — Medicare and Medicaid were established on this day in 1965. Since that day 56 years ago, the programs have become essential to the fabric of our health care system, providing coverage for seniors, low-income Americans and those with disabilities. And, it all started here. The bill was signed in Independence, Mo., with former President Truman — an early supporter of a national system to address gaps in coverage — on hand.

In This Issue

DCI Releases Proposed Health Insurance Rates For 2022
CMS Releases FY 2022 Final Payment And Policy Updates For IRF, SNF, IPF And Hospice
CMS Releases CMP Guidance
MLN Connects Provider eNews Available
SAMHSA Awards $250 Million To 100 Certified Community Behavioral Health Centers
Rural Energy For America Program Improvement Grants And Guaranteed Loans Available
Transition To Value Educational Video Series Available
CFPB Offer Resources For Renters And Landlords

Quality and Population Health
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