As with most things in the world, early 2020 seems like ancient history. In late January last year, I had just finished a white paper for the SOA, stating confidently that Electronic Health Records, or EHRs, were not likely to have a major impact for several years amid slow adoption by executives—with significant strategic differences among stakeholders and little signs of compromise.
Then in February came COVID-19, and the urgent need to move rapidly to telemedicine for both COVID and non-COVID afflictions. Government authorities moved quickly to relax restrictions on interstate telehealth, allowing payer coverage for the transfer of sensitive material online and over mobile networks—including Facebook Messenger, Apple Facetime, and Zoom. Although not permanent while a public health emergency, this created an unexpected precedent for interoperability, the Holy Grail of seamless cross-talk of health data between HIPAA-regulated IT systems.
COVID-19 Related Claims Data—Tip of a Looming Iceberg?
Much remains unknown about the secondary effects of COVID-19, beyond respiratory failure and immune system overload. However, there is likely a significant spike in claims related to COVID-19 building within the insurance industry. It may be important for the insurance industry to monitor these secondary afflictions, at minimum through the claims process (see Figure 3), although the best digital approach to obtain that evolving health information remains unclear at this time. Genomics and epigenetic vulnerability could be a rich data area here.
If insureds would be willing (or mandated) to provide their immunization history to payors, directly or indirectly, this could be a significant asset for actuaries in evaluating this ongoing phenomenon. Claims data also can include non-prescription drug information, which could provide additional clues of COVID exposure.
Author(s): James Timmins
Publication Date: October 2021
Publication Site: Actuarial Technology Today