As our team of health data scientists analyzed the data, we realized that the key to understanding the overall health care spending trend is to recognize that it is not a single trend. Instead, multiple "micro-trends" will drive the broader trend to various degrees and during different periods. These micro-trends include disruptions to elective surgeries, preventive care, acute and chronic care, and cancer care.

What does this mean? The "old normal" in the rearview mirror will no longer look like the "new normal" directly ahead of us. Things are changing, and although much is still unpredictable, what we do know is that with the right data, organizations can get ahead of the coming disruption and prepare.

Let's lean into the data

Although predicting the overall trend is overwhelming, we have a much better chance of identifying and predicting specific areas of impact via these micro-trends. So, what are we seeing?

• Preventive care visits are down. This includes wellness checks, eye exams, immunizations, and cancer screenings. According to our platform, based on data from over 2,500 organizations, April measles, mumps, and rubella (MMR) immunization rates were about 34% lower than in April 2019, and year-over-year rates for meningococcal immunization were diminished by 73%. Mammography rates diminished by almost 90% in the same time period, and colonoscopies decreased by almost 95%.These delays are concerning given the importance of early detection and health management. Employers may see a spike in diagnosis and needed medical care for their employees once more regular health care activities are resumed. This backlog and surge in future demand could create a costly environment for employers — and a huge obstacle to the health care industry's capacity to provide care.
• Elective surgeries are down. Both inpatient and outpatient surgeries have declined. A study conducted by Strata Decision Technology on year-over-year changes to hospital revenue during late March to early April shows a 99% decrease in primary knee replacements — and a 79% decrease for primary hip replacements.Although some procedures may be canceled altogether, there will likely be significant delays in rescheduling procedures and renewed postponement where COVID-19 case numbers are still high. Therefore, it's probable that the year-end impact will be an overall decrease in elective procedures in 2020 as compared with prior years — with the magnitude of the reduction likely varying by geographic area.
• There are delays in acute and chronic care. The COVID-19 crisis has also caused an increase in gaps in care related to chronic conditions, meaning instances where people aren't adhering to their normal routine of medications, physician visits, or regular tests and screenings. Data gathered from our platform shows that in April 2020 ER visits for chest pain were 35% lower than in April 2019, while abdominal pain visits were about 47% lower.These gaps in chronic care may require targeted communication strategies, telehealth opportunities, or disease-management solutions to help your members get back on track. It may also be time to remind your employees about symptoms of life-threatening conditions (like chest pain) that require immediate medical attention.
• Delays in cancer care. Our data also shows that radiation therapy rates experienced a reduction of about 7% in April and about 13% in May compared with the prior year. Radiation and chemotherapy, which also experienced a decline, are essential. By looking at micro-trends we can see that these therapies have been impacted less than other health care services, but will still need to be watched as a potential downstream issue.
• Mental health needs are skyrocketing. Mental health issues are historically common and costly for employers. It's no surprise that employees' mental health needs have gone up since the start of the pandemic — more than 9 in 10 employees now report some level of anxiety, with 55% indicating a moderate or high degree of anxiety. The new normal will need to take into account the demand and expenditure of these services compared with previous years and come up with a new approach to employee care.

What does this mean for benefit leaders?

With the significant decrease in utilization for essential health care services, it can be assumed that this reduction in current utilization is going to lead to a future influx of demand for care. This backlog of needed services will grow exponentially as current delays may cause increased complications. It's a cycle, and the health care system may struggle to keep up leading to further delays in care.

On top of that, it's important to realize how these micro-trends impact specific population segments differently, according to risk factors, geographic locations, and personal choices about seeking health care during this uncertain time.

These micro-trends could create not only a burden on the health care system but also on HR and benefits leaders' ability to plan their budgets accurately for next year. These micro-trends will need to be monitored and analyzed in an attempt to try to paint a somewhat clear picture of the future. Future planning for employee benefit packages, costs, and demand requires it.

Planning for the new normal

This is just the beginning. What the current instability and unpredictable nature of the pandemic and health care system means is that a vigilant eye needs to be kept on these micro-trends to understand what picture they are painting of our new normal and what benefit leaders will need to do to prepare for it. It certainly isn't going to be easy, but chipping away at the uncertainty one trend at a time can help — and will be critical for organizations to navigate it successfully.

Rod Reasen is the CEO of Springbuk, the leading Health Intelligence platform determined to prevent disease with data. This industry-leading platform allows employers to maximize the investment they're making in their most valuable resource — people.