Tuesday, July 17, 2018

A million here, a million there...

Over the years, we've reported on a number of health insurance claims that hit (and/or exceeded) the magic $1 million mark. These have always been rare, partly because, even in today's inflated medical expense environment, it takes a lot of medical care to reach that summit:

"Olive-McCoy, 44, has hereditary angioedema (HAE), a life-threatening disease so rare that many doctors have only read about it ... the price of just one of Olive-McCoy’s drugs will be about $600,000 this year ... she has received hospital bills for more than $1 million"

But this is apparently changing:

"The number of million-dollar medical claims has nearly doubled, with cancer care remaining the most costly health condition"

Cancers of various types accounted for almost $800 million in health insurance reimbursements fro 2014 through last year. And the total number of million dollar patients nearly doubled: from 104 in 2014 to almost 200 in 2017.

What's also interesting  to me  is that cancer was the #1 culprit: I would have guessed that the opioid crisis would have been to blame, but that doesn't seem to even register on the radar. Granted, these are from a study of self-funded plans from one carrier, but still; it's not as if employees and their dependents are immune.

What wasn't a surprise is the low percentage of folks who experienced these claims:

"Patients with claims of more than $1 million represented only 2% of the total number of stop-loss claims from 2014 to 2017."

But that low number comprised almost one-fifth of the total dollars paid out.

So, 2% ate up 20%. Interesting.
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