Prealize Health Report: Health System to See Massive Hit from Pandemic Unwellness
What will be the patient care areas involving the top at-risk conditions and the highest levels of utilization, in 2022? On Jan. 5, the Palo Alto, Calif.-based Prealize predictive analytics firm released a forecast, based on an in-depth analysis of more than 2 million medical claims and presents predictive findings and contributing factors that payers and providers should proactively address in 2022.
As noted in the press release posted to Prealize’s website on Wednesday, the report, entitled “State of Health 2022: The Domino Effect,” “states that key drivers include the troubling trends of delayed care; ongoing behavioral health challenges for adults (and new ones for children); health inequities, and an overall wellness decline of our population. The report also forecasts conditions that are predicted to be at risk for increased utilization in 2022. These include:
A 17.6-percent increase in diabetes-related medical encounters. Also of significant concern are patients already diagnosed with diabetes who will present with worsened cases in 2022.
A 22-percent increase in joint paint medical encounters and a 7-percent increase in spine-related encounters. The social and physical confinement brought on by the pandemic have decreased levels of physical activity and increased sitting time by about 28 percent.
An 18-percent increase in cardiomyopathy, 10 -percent increase in hypertension, and 9-percent increase in cardiac blocks. Significant contributors to the rise in cardiovascular diseases include the avoidance of hospitals over the past 24 months for fear of virus exposure, increased strains on healthcare systems, and deferred outpatient and procedural care.
A 14-percent increase in obesity. Lifestyle changes enforced during the pandemic have been linked to physical inactivity, overeating, and emotional eating—which has spiked during the pandemic stay-at-home orders.
A 4-percent increase in substance use. Social isolation and pandemic-related stress are likely contributing factors to increases in substance use and poor substance use outcomes. In addition, research has shown that job loss can lead to adverse behavioral health outcomes, including substance use disorder.
The introduction to the report puts things starkly: “Nearly two years since COVID-19 first erupted in the United States, the true magnitude of its influence on the health of Americans is becoming much clearer—and much more troubling. The devastating and deadly virus has unleashed a domino effect of crises that, if left unmanaged, will continue to erode population health and increase healthcare spending for years to come. These crises include a significant increase in care deferrals that have, and will continue to, lead to later stage diagnoses of previously undetected diseases and exacerbated chronic health conditions. They also include skyrocketing rates of substance use and behavioral health issues, declining rates of proactive wellness activity, and persistent problems related to healthcare access and inequities.”
This second annual State of Health Report from Prealize Health, identifies “the top health conditions and utilization spikes that healthcare leaders must act on in 2022. “The report presents the predictive findings and explores the top contributing factors, along with practical commentary from industry leaders.”
And the report quotes Linda Hand, Prealize’s CEO, as stating that “Our predicted increases in care claims are a by-product of how our society coped with the pandemic combined with the already reactive healthcare system. The negative repercussions will extend into 2022 and beyond because, as a country, we’ve fallen backwards in pushing preventive care. This new normal requires healthcare leaders to redouble efforts to promote proactive health through early detection and better member engagement. It will require a culture shift to regain trust and meet people where they are while providing additional services to communities and cohorts of the population in order to improve health outcomes. And it just may cost more to do so.”
The report focuses significantly on issues around delayed care, problems in behavioral healthcare, and the broader decline in physical and mental wellness during the pandemic.
It notes the following:
Ø A 75-percent increase in alcohol use
Ø A 54-percent increase in suicidal ideation
Ø A 45-percent increase in illicit drug use
Ø A 39-percent increase in eating disorders
Ø A 400-percent increase in depression
Ø More than 20 percent of adults with anxiety or depression symptoms not receiving mental health therapy during the pandemic
Ø 75 percent of providers surveyed in a recent Anthem study stating that the mental health effects from the pandemic will linger for up to three years or longer
Prealize also predicts a 14-percent rise in obesity this year, noting that research from the American Psychological Association has found that 42 percent of Americans gained more weight during the pandemic, and the percentage of overweight or obese children aged 5-11 increased from 36.2 percent to 45.7. Meanwhile, 16 states now report obesity rates of 35 percent or higher.
Per those issues, the report states that “Health plans cannot afford to wait to address the behavioral health crisis—more proactive interventions are the best way to keep these conditions and the costs associated with them from escalating. A behavioral health patient who has regular therapy costs on average $3,000 less per year than a member who does not get regular behavioral health therapy, according to Prealize data. Much of this cost is a result of individuals who seek emergency room care in crisis. More importantly, members are suffering needlessly without getting the help they need.”
And, per the impact on providers, it quotes Chris deRienzo, M.D., senior vice president and chief medical and quality officer at the four-hospital, Raleigh, N.C.-based WakeMed Health & Hospitals, as stating that, ““If we’ve learned anything from the past 18 months, it’s that our physical, social, and mental health are all inextricably integrated. We must take advantage of this moment to translate this learning into action, resourcing initiatives that solve for health outside of the traditional sick care system. We must embrace whole person health and pivot to provide the time, resources, and reimbursement models needed to holistically support it.”
