WELLESLEY, Mass., June 2, 2021 /PRNewswire/ -- Sun Life has released its annual research report on high-cost claims and medical trends. Cancer again topped the list of the 10 most common and costliest medical conditions, with an increase of 16 percent in 2020 despite the likely missed screenings during lockdown early in the pandemic. The report also showed that mental health claims increased by 21 percent in 2020 from 2019, with alcohol or opioid abuse and depression being the most common conditions. Septicemia (infections), one of the most common secondary conditions as a result of COVID-19, was also on the list of costliest conditions, as well as congenital anomalies (conditions present at birth, such as a heart defect) and kidney disease.
This year's report analyzed claims from 2017–2020 for more than 45,000 members. Sun Life will present a webinar on June 8 to provide insights on the report, with Jennifer Collier, R.N., senior vice president of Stop-Loss & Health; Mike Huppert, vice president of Actuarial & Risk Management; and Lisa Hundertmark, R.N., director of Clinical Services. Click here to register.
"We monitor these trends closely to make sure our employer clients and their employees get the care and support they need," said Collier. "Delayed screenings during the pandemic may result in some conditions, particularly cancer, being more advanced in their progression than they normally would have been at the time of diagnosis. It is crucial to support members with serious medical conditions and make sure they have access to the proper care and treatment, which is why we recently announced our intention to acquire PinnacleCare, a leading U.S. healthcare navigation provider that will help our members find the best physicians and centers of excellence for their specific condition."
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Mental health spotlight
The pandemic likely contributed to the notable rise in claims related to mental health. In 2020, members with a stop-loss (high-cost) claim related to a mental health disorder rose 21 percent, and overall spend on mental health claims increased nearly 25 percent. The average cost in 2020 of a mental health claim per person was approximately $80,000. Experts expect a sustained impact to mental health in the wake of the pandemic, even after it ends. According to a recent report from Kaiser Health, women with children were almost 10 percent more likely to report symptoms of depression or anxiety in 2020, and essential workers were 12 percent more likely to report mental health disorders than non-essential workers. The Kaiser report also showed that the pandemic disproportionately affected mental health in communities of color, and that healthcare workers reported more vulnerability to emotional distress due to fears of contracting the virus or infecting loved ones, as well as a more stressful work environment.