Dive Brief:
- Preventable hospitalizations from COVID-19 have cost the U.S. healthcare system billions of dollars since the beginning of June alone, according to a new analysis from the Kaiser Family Foundation.
- More than 98% of people hospitalized with COVID-19 between May and July were unvaccinated, KFF said in the brief published Friday. Roughly 113,000 of the 185,000 inpatient stays with a COVID-19 diagnosis could have been prevented by vaccination in June and July, researchers estimated.
- Various data pegs the average hospitalization cost for COVID-19 at around $20,000, so based on these estimates, avoidable COVID-19 hospitalizations cost the U.S. health system $2.3 billion in those two months alone, KFF determined.
Dive Insight:
Vaccines for the coronavirus have been broadly available to the public since mid-April of this year, and are highly effective at preventing severe disease, hospitalization and death. However, inoculation rates have lagged, and the holdouts are driving the latest surge in COVID-19 cases as the highly infectious delta variant spreads, overwhelming hospital capacity in many states — especially those with low vaccination rates.
Currently, the U.S. is recording more than 133,000 new COVID-19 cases a day — a count that has increased 14% from last week's daily average — as states like Texas, Arkansas and Kentucky report record numbers of COVID-19 patients in hospitals and ICUs, the overwhelming majority of whom are unvaccinated.
Despite the surge and ongoing pleas from public health officials, roughly 27% of adults over the age of 18 have yet to get the shot, according to the Centers for Disease Control and Prevention.
"The latest data that confirms we're still in a pandemic of the unvaccinated," President Joe Biden said in remarks at the White House on Wednesday.
Though opponents to the vaccine maintain receiving the shot is a personal choice, the new analysis from KFF determines preventable hospitalizations among the unvaccinated aren't just costing the unvaccinated: Along with taxing hospital capacity, they're also seriously costing taxpayer-funded public insurance programs, and the workers and businesses paying health insurance premiums.
To arrive at the $2.3 billion price tag, KFF looked at estimates of the cost of a COVID-19 hospitalization, which CMS puts at $24,033, FAIR Health puts at $17,094 for people over age 70 to $24,012 for people in their 50s and a National Center for Immunization and Respiratory Diseases study averaged at $21,752, to arrive at the $20,000 per-hospitalization cost for the analysis.
CDC data indicates there were 37,000 preventable COVID-19 hospitalizations in June and another 76,000 preventable COVID-19 hospitalizations in July among unvaccinated adults.
Researchers estimated the number of preventable hospitalizations by removing vaccinated adults from the number of people hospitalized with COVID-19 and narrowing that group down to hospitalizations primarily for COVID-19 treatment. Researchers then adjusted for the fact that vaccines wouldn't prevent 100% of hospitalizations to get the number of preventable hospitalizations, before multiplying the number of preventable hospitalizations by the estimated cost of each one, to get $2.3 billion.
"Still, this ballpark figure is likely an understatement of the cost burden on the health system from treatment of COVID-19 among unvaccinated adults," researchers wrote, noting COVID-19 cases, hospitalizations and deaths have continued to increase in August and the analysis doesn't include the cost of outpatient treatment, which "is likely substantial."
And the patients themselves bear very little of that cost. The typical out-of-pocket payment for privately insured patients hospitalized with pneumonia is roughly $1,300, a "significant amount for most patients to pay" but far less than the amount covered by insurance, KFF researchers wrote in the brief.
The Affordable Care Act and other laws prohibit insurers from charging unvaccinated people higher premiums, but unvaccinated people could start to see higher medical costs due to their decision. Private insurers have begun reinstating cost-sharing for COVID-19 hospitalizations, and employers could impose higher costs through wellness programs, KFF pointed out.
Additionally, on Monday, the Food and Drug Administration granted full approval to Pfizer and BioNTech's coronavirus vaccine, which could ameliorate some of the lingering skepticism among vaccine holdouts, experts say.
A recent poll also from KFF found that almost a third of unvaccinated adults would be more likely to get the shot if one of the vaccines received FDA approval.
And FDA's full approval for people 16 years old and above has already cleared the way for more institutions to impose vaccine mandates. Within hours of the approval, CVS Health, the Pentagon and the New York City school system, among others, said they would enforce vaccine mandates.