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What We’re Reading: In-Network Insurance Claim Increase; Opioid Epidemic Fourth Wave; Long COVID Prevalence

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The amount of in-network care claims jumped significantly after surprise billing protections took effect; experts say the US is in the midst of the “fourth wave” of the opioid epidemic; the prevalence of long COVID symptoms 30 and 90 days post infection was 43% to 58% lower among adults who were fully vaccinated before infection.

In-Network Insurance Claims Increased After Surprise Billing Ban Took Effect

A FAIR Health analysis reported that the amount of in-network care received by patients jumped significantly after surprise billing protections and the No Surprises Act took effect, according to Axios. For its analysis, FAIR Health used its database of about 42 billion commercial insurance claims to examine in-network claims between 2019 and the third quarter of 2023, capturing both before and after the enactment of the No Surprises Act and state surprise billing laws. It found that the share of in-network care increased from about 84% of all claims to 90% of claims nationally. Also, it found an increase in the share of in-network care for specialties among the most common surprise bill sources, like emergency medicine, radiology, anesthesiology, and pathology; during this period, in-network care for these “specialties of interest” increased from 4.7% to 88.2% of claims, with emergency medicine having the greatest increase (13.2%). Overall, FAIR Health found a narrowing gap between the in-network and out-of-network amounts allowed by payers and amounts billed by providers.

“Fourth Wave” of Opioid Epidemic Propelled by Fentanyl, Meth

The US is in the midst of the “fourth wave” of the opioid epidemic, according to KFF Health News. A report released today by Millennium Health found that the latest wave involves using multiple substances at the same time, combining fentanyl mainly with either cocaine or methamphetamine. Of 4.1 million urine samples collected from January 2013 to December 2023 from people receiving drug addiction care, nearly 93% of fentanyl-positive urine samples contained additional substances. The researchers noted that the most concerning finding is the dramatic increase in the combination of methamphetamine and fentanyl use as they reported an 875% increase in methamphetamine use since 2015. Other key findings included that both heroin and prescribed opioid use alongside fentanyl have dipped.

Long COVID Less Prevalent Among Vaccinated People

A recent study published in the Annals of Epidemiology found that the prevalence of long COVID symptoms 30 and 90 days post infection was 43% to 58% lower among adults who were fully vaccinated before infection, according to CIDRAP. The study population, which consisted of 4605 participants from the Michigan COVID-19 Recovery Surveillance Study, all had a confirmed COVID-19 case from March 1, 2020, to May 31, 2022. Of the population, 32.2% of patients reported long COVID at 30 days and 17.5% reported long COVID at 90 days. The researchers noted that the prevalence of 30-day long COVID was 43% lower among the vaccinated group (prevalence ratio [PR], 0.57; 95% CI, 0.49-0.66), and the adjusted prevalence of 90-day long COVID was 58% lower among the vaccinated group (PR, 0.42; 95% CI, 0.34-0.53). Overall, these findings showed that COVID-19 vaccination may be an important tool for reducing long COVID burden.

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