An analysis from Cedar Gate Technologies (Cedar Gate) reveals that only 34.7% of commercially insured patients diagnosed with chronic obstructive pulmonary disease (COPD) or asthma are receiving their annual flu shots, leaving them vulnerable to severe complications and higher treatment costs. Data from the 2022-2023 flu season shows that, despite the well-known risks, these high-risk patients skip vaccination at alarming rates, which can result in more emergency room visits and hospital admissions.
Low vaccination rates increase the risk of adverse outcomes for patients with one or more chronic diseases. Influenza infection in patients with COPD has been linked to risks of pneumonia, respiratory failure, and ischemic stroke. Asthma patients who get the flu are at higher risk of inflammation, narrowing airways, and pneumonia.
Cedar Gate’s analysis also found that the per-event cost for treatment of flu-related illness was almost three times higher for COPD and asthma patients at $952.01, compared to average costs for someone without either chronic health condition at $359.52 per event.
Higher costs are correlated with where patients seek treatment for flu-related illness:
- Nearly one-third of COPD patients (32.6%) went to the emergency room or were admitted for hospital inpatient care for influenza
- That is four times higher than the 8% of patients without either chronic condition who went to the ER or hospital for flu-related care
- Over 85% of flu treatments for people without a COPD or asthma diagnosis took place in a lower-cost setting, such as a doctor’s office, urgent care center, or telehealth appointment
Of the members in Cedar Gate’s National Healthcare Benchmark Database with a COPD diagnosis, just 35.5% received a flu shot, and only 34.5% of members with an asthma diagnosis got vaccinated for the flu. Overall, about 3 in 10 eligible patients (29.16%) received a flu shot the same year, based on pharmacy claims data.
Cedar Gate uses predictive AI models to determine whether someone is likely to get an influenza vaccine. The AI model revealed that nearly two-thirds (65.5%) of all members in the database are unlikely to get a flu shot this year.
“As flu season approaches, predictive data from Cedar Gate’s analytics tools can help healthcare organizations identify patients at higher risk of complications from the flu and develop outreach strategies to prevent or reduce the severity of the illness,” said Dee Ann Bialecki-Haase, MD, and VP, Senior Medical Officer at Medical Mutual. “Giving payers, providers, and employers data that helps them intervene sooner and take preventive measures can improve patient outcomes and lower the total cost of care.”
Flu vaccines are one of the most effective ways to prevent seasonal flu, according to the Centers for Disease Control and Prevention (CDC). However, the CDC estimates that less than half of people in the U.S. eligible for a flu vaccine actually get one, and the number is declining. Those estimates are based on respondents’ answers to survey questions and may not capture the full picture of how many people skip flu vaccines each year. Cedar Gate’s data helps payers, providers, and employers pinpoint patients and members within their population at risk of missing out on this important preventive measure to increase flu vaccination rates.
Cedar Gate’s National Healthcare Benchmark Database includes claims data for approximately 15 million commercially insured members. Payers, providers, and self-funded employers use the database to benchmark performance, uncover trends within their own populations, and identify actionable steps to improve care and outcomes. All the information in the database is anonymized and thoroughly de-identified to protect patient privacy.
About Cedar Gate
Cedar Gate enables payers, providers, employers, and service administrators to excel at value-based care with a unified technology and services platform delivering analytics, care, and payment technology on a single data management foundation. From primary care attribution, to bundled payments, to capitation, Cedar Gate is improving clinical, financial, and operational outcomes for every payment model in all lines of business.
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