FAIR Health Releases COVID-19 Total Treatment Cost Benchmarks

FAIR Health has released new FH® Total Treatment Cost benchmarks for COVID-19. The newly expanded FH Total Treatment Cost benchmarks cover three different beginning-to-end treatment pathways for COVID-19, illuminating typical total costs for diagnosis and for professional and facility services associated with treating the disease.

COVID-19 can vary greatly in severity, and treating COVID-19 can involve a multiplicity of services, supplies, tests and physician-administered medications. FH Total Treatment Cost COVID-19 benchmarks offer the first opportunity to understand, in their entirety, the typical total costs associated with differing COVID-19 treatment protocols at varying levels of severity of the disease. The new benchmarks also provide a window into the most common types of services being performed for the different severity levels of COVID-19 patients.

FH Total Treatment Cost COVID-19 benchmarks provide estimates of typical costs for three possible pathways of treatment:

  1. Non-hospitalization. Captures the typical total costs for a patient who has been diagnosed with COVID-19 but does not require hospitalization. Costs might include laboratory testing and physician or urgent care visits.
  2. Hospitalization. Captures the typical total costs for a COVID-19 patient who is admitted to the hospital but does not require ventilation or admission to the intensive care unit (ICU). Costs in this pathway include room and board, laboratory testing, imaging and IV therapies.
  3. Hospitalization with complexities. Captures the typical total costs for the most serious cases of COVID-19, in which a patient is admitted to the hospital and requires ventilation or admission to the ICU. This pathway includes costs for a hospitalized patient who requires more complicated care, such as ICU costs, ventilator costs and costs for room and board of increased complexity.

Payors and providers can use FH Total Treatment Cost COVID-19 benchmarks as a tool for future budget and resource planning. The new benchmarks will also support government entities by providing insights into healthcare spending.

FH Total Treatment Cost COVID-19 benchmarks include charges and estimated allowed amounts, organized into mean, 50th and 80th percentiles. Users will be able to understand typical diagnosis and treatment costs associated with the most common types of services being performed for the different severity levels. The benchmarks are grouped into 493 geozips—geographic areas generally based on the first three digits of a zip code—allowing national and local comparisons. The data come from FAIR Health’s immense database, the largest repository of private healthcare claims in the nation, and are current, based on a recent 12-month window of claims and refreshed twice a year.

The FAIR Health COVID-19 cost benchmarks are available in multiple formats:

  • An easy-to-use executable file with drop-downs that allow the user to select the condition and see related costs for all services typically associated with the treatment pathway. Data can be viewed and downloaded to Excel reports.
  • Flat file formats that can be loaded to the user’s internal systems.

FAIR Health President Robin Gelburd stated: “We are excited to provide benchmarks for the total costs of the differing treatment pathways for patients diagnosed with COVID-19 and shed further light on the impact of the pandemic.”

For more information on the new FH Total Treatment Cost COVID-19 benchmarks, contact FAIR Health by email at info@fairhealth.org or call 855-301-3247, Monday through Friday, 9 am to 6 pm ET.