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The COVID-19 pandemic ultimately impacted individuals of all ages, genders, and health status, but it became clear early on that certain pre-existing conditions had a significantly higher chance of poor outcomes. Conditions like diabetes, hypertension, and cancer had higher rates of severe illness, hospitalization, and death. Most of the conditions that produced poor outcomes for COVID-19 also produce higher costs and poor outcomes in non-pandemic times. Furthermore, they are some of the most prevalent conditions found in workforces.

Top Chronic Conditions and Risk of Severe Outcomes

Of the top 10 conditions in the IMA People Analytics database, six of those conditions had increased risk of severe illness related to COVID-19 according to the . These chronic conditions are not only high prevalence, they are also high cost. Based on risk score, which is a measure of expected cost, these conditions ranged in cost from two-times the typical member to four times the typical member, even prior to the COVID-19 pandemic.

IMA People Analytics: Top 10 Chronic Conditions
Condition	Prevalence	Risk Score
Hypertension*	13.2%	2.43
Hyperlipidemia*	10.5%	2.31
Lower Back Pain	9.9%	1.96
Depression	6.7%	2.04
Diabetes	5.6%	3.20
Blood Disorders*	5.0%	3.40
Asthma	4.8%	1.93
Osteoarthritis	4.1%	2.92
Cancer*	3.2%	4.00
ADHD	2.9%	1.43
Ìý	Ìý	Ìý

Typical Member Risk ScoreÌý Ìý Ìý Ìý Ìý Ìý Ìý Ìý Ìý Ìý Ìý Ìý Ìý Ìý Ìý Ìý 1.00
* Condition with significant comorbidities related to covid-19

Lifestyle Conditions and Wellness Impact

Three of the top five conditions by prevalence – hypertension, hyperlipidemia, and diabetes – are conditions associated with lifestyle and are frequent targets of condition management and wellness programs. COVID-19 was a severe event that produced poor outcomes for these individuals. This provides potential for renewed focus on managing, or even avoiding, these lifestyle conditions through wellness programs.

Depression and Mental Health

A seventh chronic condition – depression – had increased importance as a result of COVID-19, as social and economic disruptions led to increased prevalence and utilization of mental health care. In the case of depression, mental health claims were one of the only condition categories that increased in cost and utilization through 2020 and 2021, a time when people were avoiding many healthcare services due to lockdowns. After the pandemic, mental health costs have remained elevated, 10-20% higher than prior to the pandemic. Depression brings its own risk of comorbidities and increased costs. Someone with a physical condition and depression sees the cost for their physical condition increase in cost at a rate similar to if their comorbid condition was diabetes.

Conclusion

COVID-19 produced severe outcomes for those with some of the most prevalent chronic conditions. While some of these are unavoidable, several are lifestyle-related and frequent targets of health and wellness programs. COVID-19 was a severe and highly visible example of poor outcomes due to comorbid conditions, and many employers are recognizing this as a catalyst to invest in improving workforce health and wellness.

Our Whole Health strategies aim to equip clients with solutions that address not only physical health and wellness, but mental health and financial health. Through an analytics-driven strategy, we identify trends and traits in your organization, and combine that with our experience with similar groups to bring the appropriate solutions and tools to your employees to manage the health, well-being, and financial wellness of your organization and its employees.

IMA will continue to monitor regulator guidance and offer meaningful, practical, timely information. This material should not be considered as a substitute for legal, tax and/or actuarial advice. Contact the appropriate professional counsel for such matters. These materials are not exhaustive and are subject to possible changes in applicable laws, rules, and regulations and their interpretations.