[SECTION 1] Impact of COVID-19 on the consumption of medical services

• What are the “consumption” effects of this health crisis on the healthcare economy?
• How are the French behaving during this period of confinement?
• Optics, dental, routine healthcare… how has demand evolved?

GEREP, a broking firm specialising in group insurance programmes, has set out to study changes in consumption and the behaviour of its insured persons during this health and economic crisis based on a survey conducted with a significant share of its client portfolio (a panel of around 60,000 of its programme beneficiaries).

The study was carried out right from the official announcement of the first Covid-19 cases (24 January 2020) and continued on a weekly basis (from the week of 20 January to the week of 19 April, i.e. 13 weeks data).

It is clear that delayed or deferred effects of confinement will begin to appear later on, in the medium to long term, with the emergence of health conditions arising from confinement. But what about the immediate short term?

Main conclusions as to the “consumption” impact on complementary “second tier” health insurance

A sharp drop in healthcare benefits : -31% over the period studied vs 2019 (20 January to 19 April)

The first effects on the healthcare economy of the health and economic crisis caused by the Covid-19 pandemic and confinement of the population, are beginning to appear. It is no surprise that the GEREP study reveals that the Covid-19 crisis is far from having a neutral effect on French healthcare spending.

Indeed, there has been a significant drop in reimbursements, particularly from 16 March onwards, the start of confinement.

• Over the first 13 weeks of the health crisis, the survey found a drop of 31% compared to the same period in 2019.  The trend accelerated as from the week when confinement was announced (-65%), followed by significant drops in the weeks of 23 March, 30 March, 6 April and 13 April (-77%, -78%, -80% and -84% respectively, in terms of healthcare spending, i.e. an average drop of 80%).
• The trend accelerated as from the week when confinement was announced (-65%), followed by significant drops in the weeks of 23 March, 30 March, 6 April and 13 April (-77%, -78%, -80% and -84% respectively, in terms of healthcare spending, i.e. an average drop of 80%).

Situation varies depending on expense type The GEREP study also set out to take a detailed look at the impact of confinement on the main expense types that make up 80% of expenses covered by complementary health insurance, i.e.:

• Optics: 26% of reimbursements
• Dental: 21% of reimbursements
• Consultations: 11% of reimbursements
• Hospitalisation: 11% of reimbursements
• Pharmaceuticals: 10% of reimbursement

1- Optical sector: -55% over the period studied vs 2019 (20 January to 19 April)

An initial drop, linked directly to “100% Healthcare”, was seen at first (-32% on average) before the very sharp drop of 90% in consumption during confinement.

• An initial drop, linked directly to “100% Healthcare”, was seen at first (-32% on average) before the very sharp drop of 90% in consumption during confinement.
• It is furthermore interesting to note that frames fell 55% over the period under study compared to 2019.

2- Dental: -30% over the period studied vs 2019 (20 January to 19 April)

Implementation of the “100% Healthcare” reform, which takes into account the position of the tooth and the material used for a denture, has in fact tended to increase reimbursement levels since the beginning of the year. The confinement period, with dental practices closed, has reduced consumption to practically zero.

• Indeed, the GEREP study reveals a sharp drop in the consumption of dental treatment: a fall of almost 90% right from the first week when confinement was announced, 98% in the week of 6 April and nil consumption in the week of 13 April.

3- Routine treatment

There has been a clear decrease in consultations and doctors’ visits, both for consultants and GPs, most certainly due to people in France being afraid of going to the doctor.

• GPs: -19.5% on average over the period peaking at -68% in week 13.
• Consultants: -20.5% on average over the period peaking at -79% in week 13.

As for pharmaceuticals, the study showed two stages:

• Up to early April, the study found people in France were much less reluctant to go to a pharmacy. In fact, no impact of confinement was observed and actually an increase of 1.5% took place.
• However, a sharp drop of 33% has been recorded over the last two weeks (making an average of -11.33% over the 13 weeks).

However, the time lag in accounting for hospitalisation expenses (processing direct payment of hospital fees by third parties and other accounting time lags) means that no significant trend is visible, at least for Q1. A shortfall of 8.4% over 13 weeks appears but with significant variations from week to week.

However, the time lag in accounting for hospitalisation expenses (processing direct payment of hospital fees by third parties and other accounting time lags) means that no significant trend is visible, at least for Q1. A shortfall of 8.4% over 13 weeks appears but with significant variations from week to week.

 “In order to estimate the overall economic impact on complementary healthcare insurance, one should include the measures contained in the insurers’ support scheme – particularly delaying premium payment and maintaining cover – as well as the impact of unpaid premiums when companies default, the portability of covers if unemployment rises and the impact of furloughing.

Even though it is too early to measure the impact of the crisis, we know already that this will go beyond questions of healthcare:  especially financial, economic and insurance impacts.  The costs of the pandemic will not be limited to human casualties, but will also include the physical effects on those infected, as well as mental trauma.

Some specialists are talking of symptoms of traumatic stress, confusion and anger. All these factors are made worse by the fear of infection, limited access to basic necessities, fake news and economic hardship. In addition, it has been shown that stress and anxiety can lead to an increase in domestic violence as well as an increase in alcohol consumption. “