Impact on the consumption of medical services #Section 6

January to May 2021

What are the “consumption” effects of the continuation of this health crisis on the healthcare economy?

How are the French behaving during this period of “post-confinement”?

Optical, dental…how has demand evolved for these major expense items in 2021?

GEREP, a broking and insurance management firm specialising in group programmes, closely studies, through regularly published barometers, the impact of the health crisis on the consumption of medical services by its insured persons (a panel of around 60,000 beneficiaries).

Whilst Social Security has reported an increase in treatment refunds, GEREP has sought to continue, with its barometer, to study the impact of the COVID-19 crisis on medical expenses claimed under complementary health insurance schemes (5 surveys from April 2020 to January 2021 have already been published). Where are we at, one year on? Have things picked up?

The state health insurance scheme has reported over the first five months, an increase of 6.8% over two years. For GEREP, this sixth survey has allowed us, for the first time, to monitor data over three years (on studying the first five months of the year).

The last study set out to round off observation of the year 2020 which was an exceptional year from the point of view of the consumption of medical services. The figure over 52 weeks was seen in the end to be a decrease of 11% (January 2021).

A quick reminder of the results of our previous surveys

As from March 2020, GEREP began studying the impact of Covid-19 on consumption of a panel of insured persons in its portfolio (60,000 beneficiaries) in terms of healthcare expenditure.

Surveys #1 & #2 concentrated on the first few weeks of the year just before and during the first lockdown (confinement).

Survey #3 was an analysis of the first lockdown (the period from 17 March 2020 and closing off on 11 May 2020).

Over that period consumption was measured as being a drop of 61% (over a period of 9 weeks).

The main expense categories examined in more detail represented 80% of total expenditure (optical, dental, consultations/visits, hospitalisation and pharmacy).

The most noticeable features were :

• Optical and dental: the drop observed over the nine weeks was over 90% with quite simply no refunds at all in one case (a drop of 100% in the week of 12 to 18 April 2020);
• During the last weeks observed and after lockdown: dental expenses picked up more than optical

Survey #4 showed how things had taken off again “post-confinement” and pointed towards an estimate for the year.

Survey #5 in January 2021 enabled a summary for the year to be made showing almost complete pick-up.

In the end, our various surveys have shown the following:

• Batches #1 & #2: we had anticipated a greater upturn than that which we finally observed;
• Batches #3 & #4: we corrected our projections and ended up with a fairly good estimation of how it turned out.
• Batch #5: the partial take off in survey #4 was confirmed.

year on… return to normal on average but dynamic consumption in dental treatment

Return to normal for healthcare services in 2021: +1% over the period studied (3 January to 22 May 2021) vs 2019, compared to -29% over the same period in 2020 vs 2019.

After observing a drop in consumption of medical services in 2020 due to the first lockdown, we have seen a return to normal in terms of complementary health insurance refunds since then. Over the first five weeks of 2021, it would appear that the average per week per beneficiary has increased by 1% compared to 2019 figures. A sharp drop of -60% had been seen as from week 11 in 2020, the explanation being the start of lockdown. Insurance refunds have progressed since then and now show an increase of +6% in 2021 compared to the same period in 2019.

Optical sector: -5% over the period studied (3 January to 22 May 2021) compared to 2019

Consumption of optical services in 2021, a period during which frames were at EUR 100 maximum in policies and a curfew had replaced lockdown, was logically half way between 2019 figures (when frames were at EUR 150 maximum in policies before the pandemic) and 2020 figures (when frames were at EUR 100 maximum and lockdown strict).

The survey shows a partial pick-up during the same period in 2021.

A certain volatility in consumption (a succession of peaks and troughs) has been noticeable in 2021 compared to 2019.

Dental: +16% over the period studied (3 January to 22 May 2021) compared to 2019

As the previous study suggested, contrary to frames, the pick-up is most distinct in dental services.

An explanation should be sought more in the 100% Healthcare reform which introduced baskets with no, or only moderate copays and which have boosted refunds under complimentary schemes in 2021.

Postponements from 2020 over to 2021 have also played a role in the inflation of dental and denture refunds.

Conclusion:

After the limited pick-up seen at the end of 2020, the first months of 2021 show a tendency toward consolidation of consumption.

The inflation of dental care and dentures has been catalysed by the 100% Healthcare reform, which is the reverse seen in spectacle frames where basket A does not weigh heavily (between 4% and 8%) in terms of frames overall (baskets A and B).

On the whole, a normal inflationary trend has been seen over two years despite distinct observations in dental services.

2020 remains therefore an exceptional year with 2021 seeing a return to normal.