April 2021 – As COVID vaccines continue to roll out across the country, their related claims have begun rolling in for our clients’ APCDs. Data sets being delivered by Onpoint now provide our clients and their data users with the opportunity to study the administration of vaccines by age, gender, geography, and other factors to better understand this phase of the pandemic.
As analysts begin working with the data, here are some key trends to keep an eye on:
- Fewer claims for vaccinated healthcare workers. While many front-line healthcare workers were vaccinated first, their doses often are covered directly by their employers without filing a corresponding insurance claim. This will prevent the APCD data from providing the full count of vaccinations and their associated costs.
- Medicaid and Medicare file first. Since nursing home residents are among those most at risk, their vaccination was prioritized early. Consequently, many of the first vaccination-related claims have been arriving from Medicaid and Medicare payers covering members in long-term care facilities. Utilization rates should even out as vaccinations become more widespread.
- Vaccines are free, but the needles aren’t. While insurers often require members to cover part of their healthcare costs as a copay, coinsurance, or deductible, COVID vaccinations are provided to patients at no cost. Providers, however, still submit a bill for administering the vaccine to recover the cost of providing the service with no dollars being charged to the patient.