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COVID-19












COVID-19 2020 Cost Impact Modeling




Sample Client

Total Members 19,525
Med/Rx Claims PMPM: $ 552.00


Total Costs, % Claims
Members PMPM Rounded Increase Comments:
Non Infected, Not Tested 14,960 $ - $ - 0.0% The infection rate varies based on member location using IHME projections.
Non Infected, Tested 1,496 $ 1.95 $ 460,000 0.4% Testing and associated testing costs are fully covered.
Asymptomatic Infected 1,467 $ - $ - 0.0%
Mild 1,298 $ 2.72 $ 640,000 0.5% Many infected members will have no symptoms, otherwise only require outpatient services.
Moderate 229 $ 1.07 $ 250,000 0.2%
Severe (requiring inpatient stay) 64 $ 5.53 $ 1,300,000 1.0% The hospitalization rate varies based on member age distribution.
Critical (requiring ICU) 11 $ 2.80 $ 660,000 0.5% The hospitalization unit cost also varies by member location, using Infolock data.
Subtotal Before Offset 19,525 $ 14.06 $ 3,290,000 2.5%

Offsets for Deferred/Eliminated Care 19,525 $ (12.08) $ (2,830,000) -2.2% The CDC has recommended that elective or non-essential care be delayed.


Net Impact, after Offset 19,525 $ 1.98 $ 460,000 0.4% This is the impact if COVID-19 treatment is not subject to member cost sharing.

Employee Cost Share for Treatment 19,525 $ (1.35) $ (320,000) -0.2% This assumes an AV of 86%.

Net Impact, after Offset and Cost Share 19,525 $ 0.64 $ 150,000 0.1% This is the impact if COVID-19 treatment is subject to member cost sharing.

Prepared for: Vidant Health
Sample client


Results are directional and provide a sense of scale and inform employer decision points. COVID-19 data is dynamic and evolving. Model results will change as new data becomes available


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