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Is a year’s worth of pent-up medical care about to hit?

There may be a wave of patients needing care that they put off due to the pandemic. An April 21 Healthcare Dive story cites Anthem’s CFO’s sanguine take on it.

As the COVID-19 pandemic upended our lives over the past year, many people delayed aspects of their medical care and postponed elective procedures. But now that the country is starting to open up again, experts are pointing to a sizeable wave that’s about to crest. It’s a wave of people resuming doctor’s appointments for routine care, tending to chronic conditions, and opting for procedures they’ve been putting off. This means that “volumes”—i.e., the raw numbers of people going to their providers for care—could see a dramatic spike in the coming months.

Healthcare Dive reports that, when asked about the likelihood of a surge in patient volume due to pent-up care needs, health insurer Anthem’s Chief Financial Officer John Gallina didn’t seem too worried. On a mid-April investor call, he sounded an optimistic note, to the effect that Anthem doesn’t believe that there is a “giant backlog.” But third-party analysts disagree.

We have to wonder: Why the denial? We’ve noted before that Anthem’s done well for itself during the pandemic, with profits going up as claims have substantially dipped, while COVID-19 kept millions of people home. Healthcare Dive points out that the insurer’s net income grew more than 9% compared to Q1 of 2020, thanks to strong performance by its pharmacy benefit management arm and sizable growth in Medicaid membership (not to mention Anthem’s new Ohio contract). So to us, it’s no wonder why Anthem would want to downplay the surge.

Is Anthem actually trying to dismiss the idea that it will soon have to cover a bigger volume of care, rather than risk disappointing stockholders expecting more pandemic profits? Meanwhile, if this medical tsunami does come to pass, will Anthem be willing to pay their share? Or will they pass the “losses” on to their members, passing the buck to people on their insurance plans in 2022? We’ll be paying a lot of attention—and hoping that’s all we have to pay.

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