COVID-19 Chronic Condition Patient Population Report

Chronic conditions are the leading cause of disability and death in the United States, and also the primary driver of the nation’s annual healthcare costs, which topped $3.5 trillion in 2018. In fact, 90% of the nation’s healthcare expenditures are for those with chronic conditions. When you look at those affected, six in 10 adults in the U.S. have one chronic condition, and four in 10 have two or more chronic conditions. The COVID-19 pandemic has brought unique attention to this group, given their vulnerability and high risk status for severe illness from COVID-19.

Wellframe, the market leader in digital health management solutions, sought to better understand how COVID-19 has impacted the chronic population, in an attempt to better serve this group and identify recommendations for improving their health and wellbeing. To this end, in May 2020 Wellframe surveyed a group of more than 800 adults in the United States with one or more chronic conditions. The results elucidate how this population has been interacting with the healthcare system during the COVID-19 pandemic, their confidence in managing their condition and the tools they feel would be most beneficial on their path to better health. 

Perhaps the most telling is that 74% say that the pandemic has motivated them to take better control of managing their health. However, among this group, more than half (57%) have delayed receiving healthcare services. The data prompt many questions including, what does this mean for the system as a whole in the coming months as restrictions lift and more chronic individuals seek care? With more than one quarter (26%) having trouble accessing their doctor about a chronic condition, will their health deteriorate, leading to more health problems and costs in the near future? How can the system best support this group and what role do health plans, providers, and technology all play in this equation?

Additional key findings include:

The impact of this global pandemic will be felt for years – on our healthcare system, our economies and our personal lives. When it comes to the group surveyed, nearly three quarters state an optimistic outlook on their future health, as a result of COVID-19. Specifically, 74% say that the pandemic has motivated them to take better control of managing their health. However, among this group, more than half (57%) have delayed receiving healthcare services due to the pandemic – at either their own discretion or that of their doctor. Furthermore, more than one in four patients (26%) have had trouble accessing their doctor amidst the COVID-19 crisis, with that number jumping to nearly one in three (31%) among people under age 29. 

While it’s promising that many of those surveyed are motivated to better control their physical condition, it’s unfortunate that healthcare services are being delayed. Given the burden providers are currently facing, there is ample opportunity for health plans to fill this gap and assist chronic patients in better understanding their condition, how to manage it effectively and how to lead a healthier life with tools such as nutrition advice and stress management, among others. 

For those managing one or more chronic conditions, it’s common to juggle multiple medications, visits with specialists and recommendations about lifestyle factors such as nutrition, stress management and exercise. Those elements are often referred to as a healthcare regimen, or a healthcare provider’s recommendation for controlling and improving a patient’s chronic condition.

Most respondents (87%) are familiar with the detriments associated with not following their healthcare regimen, and more than one in five (21%) have incurred additional medical visits and expenses as a result of not following their prescribed regimen. The need to bolster healthcare regimens is evidenced by the fact that more than one third of respondents (38%) are not fully confident in their ability to manage their chronic condition. However, more than half of respondents (52%) report that they have not been provided with a healthcare regimen by their doctor, which is problematic.

The topic of healthcare regimens naturally leads to adherence and a patient’s willingness and ability to follow their provider’s recommendations. When it comes to the reasons why people do not follow their healthcare regimens, the majority (28%) say they feel great and don’t need to. Other reasons include aversion to change, cost concerns and lack of understanding. In fact, nearly 40% (38%) of respondents are not fully confident in their ability to follow their healthcare regimen. 

The data show that there needs to be more accountability on behalf of patients and more structure around designing a healthcare regimen in an effort to improve health outcomes for this group. The fact that only 48% of those with chronic condition(s) have received a healthcare regimen begs the question: do providers have the time and resources to fulfill this obligation? Given COVID-19’s impact and strain on the healthcare system, the stakes are higher and this question becomes more pertinent than ever. The data and current climate illustrate the need for other stakeholders within the healthcare ecosystem to play a bigger role. Specifically, there is sufficient opportunity for health plans to serve this population due to their resources, both in terms of manpower and technology. 

The data clearly demonstrate that COVID-19 has impacted the way individuals with chronic conditions interact with the healthcare system and view their overall health. As they look to better manage their conditions, they face new obstacles including barriers to receiving care from providers, lack of structure around healthcare regimens and lack of knowledge around managing conditions from their homes. While some of these hurdles may have been in place before the pandemic, it’s clear that the path forward for this group looks much different now than it did before COVID-19 hit.

Care management has become an industry standard designed to support those with chronic conditions through a patient-centered approach, with the aim of improving health outcomes and reducing costs. While care management is critical for chronic individuals, more than one third (37%) are unfamiliar with the term. This number jumps to 43% among those younger than 29 years old. Once they were informed of the definition, 60% (and 71% under age 29) felt as though medical advice from care managers would reduce their medical visits and expenses. 

As we persevere through today’s COVID-19 environment and prepare for the future, the words contactless, remote, virtual and distant will be used to describe many experiences, including healthcare. When surveyed on the appeal of virtual care management, respondents were strongly in favor. Specifically, 68% think access to virtual support from a care management team would help them stick to their doctor’s recommendations during the COVID-19 pandemic. This includes 61% of people over 45 and 79% of people under 29, implying broader adoption by younger generations and popularity for the future. A large majority of respondents (71%) said they would use a virtual care management team to understand COVID-19 symptoms and 66% said they would want to understand how COVID-19 affects the management of their chronic condition. Among the 26% of those who have had trouble accessing their doctor due to the pandemic, 82% would use a virtual care management team to understand COVID-19 symptoms.

As individuals navigate COVID-19, they are faced with more concerns than just their physical health. The economic downturn has created a situation worse than the Great Depression, leading to unemployment on a massive scale. Physical concerns aside, COVID-19 has illuminated behavioral health issues related to stress and anxiety. Throughout the pandemic, Wellframe’s platform has seen a 40% increase in member inquiries about stress and anxiety. To address these issues, 66% of respondents (and 74% under age 29) said they would use a virtual care management team to manage mental health challenges exacerbated by COVID-19. Along those lines, a majority of respondents (29%) identified stress management to be the most helpful resource on their path to better health, outweighing other options including nutrition guidance and help with weight loss.

The COVID-19 pandemic has forever changed the way we view the world. This is particularly true for the chronic population as they evaluate their conditions and path toward better health. Patients with chronic conditions are more concerned than ever before about their health, so now is the time to capture this interest and awareness and give them the tools and resources they need to take charge of their health.

As the provider/patient relationship shifts due to obstacles brought about by COVID-19, there is increased appetite for tools such as virtual care management. There are also new opportunities for health plans to recognize their potential in assisting the chronic condition population with the goal of ultimately improving health outcomes and lowering costs over time. All stakeholders have a role to play in transforming the delivery of healthcare services, but health plans are uniquely equipped with the resources to change the way chronic condition patients interact with the healthcare system. As is the case with virtual care management technology, there is low awareness about the tools and support services insurers offer to their member base. Nearly one in three respondents (31%) are not aware that a health plan can offer advice on picking a doctor. While awareness is low, potential is high, especially for younger individuals. Case in point: 67% of respondents (and 79% of those under 29) said they would take advice from a health insurer when choosing a doctor for their healthcare needs.

COVID-19 has put many things in perspective, including the need to better serve the chronic population. As the healthcare system undergoes a pivotal shift, now is the ideal time to leverage resources such as virtual care management and empower health plans nationwide to fill gaps in care and meet the unique needs of chronic individuals.

Wellframe collected responses via a third-party provider from 884 U.S.-based patients, 18 years and older in May 2020. Respondents all had one or more chronic conditions including allergies, anemia, anxiety disorders, asthma, chronic dry eye, chronic pain, depression, gastrointestinal disorders, high cholesterol, hypertension, hypothyroidism, insomnia, osteoarthritis and type 2 diabetes. Wellframe used the responses to determine the findings of its COVID-19 Chronic Condition Patient Population Index.