Health Plan Weekly

Unlike during previous recessions, the national uninsured rate held steady at 11% during the COVID-19 pandemic and its resulting economic fallout, according to a recent analysis by the Urban Institute and Robert Wood Johnson Foundation. Between March 2019 and April 2021, the share of nonelderly adults covered by employer-sponsored insurance declined from 65.0% to 62.3%, while the share of enrollees with public coverage jumped from 13.6% to 17.5%. States that had not expanded Medicaid under the Affordable Care Act saw a higher uninsured rate in 2021 (18.2%) than in 2020 (16.5%) and 2019 (17.2%). In Medicaid expansion states, that rate remained around 8% across all three years.

Hoping to boost enrollment in the struggling Medicare Diabetes Prevention Program (MDPP) expanded model, CMS has proposed changes that would increase reimbursement and significantly shorten the services period for participants. While stakeholders agree that the changes are needed, some warn they’re only incremental steps to shore up the MDPP, which has faced a shortage of suppliers and challenges posed by the requirement that the program be delivered to beneficiaries in person.

“The MDPP rules and regulations, including the payment mechanism and the two-year commitment — in contrast to one year for the CDC DPP [U.S. Centers for Disease Control and Prevention Diabetes Prevention Program] — have made enrollment very difficult if not impossible for MDPP suppliers,” asserts Liz Joy, M.D., senior medical director for wellness and nutrition at Intermountain Healthcare.

Now that actuaries have more information about how COVID-19 affects health care spending, individual market insurers are more likely to include adjustments in their 2022 rates to account for the pandemic, concludes a new issue brief from the American Academy of Actuaries. However, “those impacts are not expected to be material,” the brief says, perhaps conflicting with the gloomy view of the pandemic’s trajectory that is dominating media reports.

Academy Senior Fellow Cori Uccello explains that while more information is now known about how the pandemic has affected health care spending and utilization since early 2020, “just because COVID may have had a big impact in 2020 and 2021 doesn’t necessarily mean it’s going to have a big impact on 2022.”

In mid-August, the U.S. Census Bureau released additional results from the 2020 Census that underscored just how diverse the country has become. While people identifying as white remained the largest ethnic group in the U.S., that population has decreased by 8.6% since 2010. Meanwhile, the Hispanic or Latino population grew 23% over the last decade and the multiracial population ballooned from 9 million in 2010 to 33.8 million in 2020.

With all that demographic change, industry observers say it’s more crucial than ever for health care organizations — especially health plans — to tailor their member engagement strategies to connect with enrollees from a wide variety of backgrounds. But they caution that doing so requires more than just lip service and cursory efforts.