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Peterson-KFF Brief: Potential Costs of Coronavirus Treatment for People with Employer Coverage

Peterson Center on Healthcare / KFF released a new brief examining the potential cost to employer health plans and their enrollees of COVID-19 treatment by looking at typical spending for hospital admissions for pneumonia. They use a sample of the IBM MarketScan Commercial Claims and Encounters claims database, which includes claims from 18 million people enrolled in large employer plans in 2018. Specifically, they look at the costs of admissions for people with pneumonia, including three diagnosis-related groups (DRGs) for pneumonia without complications or comorbidity, with complications or comorbidity, and with major complications or comorbidity. These DRGs include pneumonia caused by similar (SARS-associated) coronavirus, as well as other viruses and bacteria. DRGs are groups of similar diagnoses for which the same level of hospital resources are generally required. (It is important to note that at this time, there are no curative treatments for the new coronavirus infection itself; rather, treatment addresses the complications from COVID-19-related illnesses). This sample is limited to people under age 65.

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