{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T17:46:12Z","timestamp":1791740772532,"version":"4.3.4"},"reference-count":34,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T00:00:00Z","timestamp":1791417600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100000030","name":"Centers for Disease Control and Prevention","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["P30CA046934"],"award-info":[{"award-number":["P30CA046934"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Med Care Res Rev"],"abstract":"<jats:p>The objective of this study was to quantify expenditures for long COVID (LC) before\/after diagnosis and compare 3-year trajectories with similar patients without LC in claims. A retrospective cohort study was conducted using Colorado All Payer Claims Database multi-payer claims (October 1, 2020\u2013August 1, 2024). Adults with \u22651 U09.9 code and 1-year continuous enrollment pre-index were followed 1 year pre- and 2 years post-index. Multipart models addressed right-censoring; clustered bootstraps produced confidence intervals overall and by age, sex, and payer. Sample: 25,229 LC and 126,089 comparison patients across commercial, Medicare, Medicaid, and dual coverage. LC patients averaged $79,777 total expenditures over 3 years and $5,158 in cost-sharing. Spending rose about 6 months before the index date, peaked just before the index date, and returned to baseline within 6 months; excess spending totaled $21,597 per patient. Dual-eligible patients had the highest absolute expenditures but lowest relative increase, whereas Medicaid had the lowest absolute expenditures and highest relative increase. LC patients had a substantial financial burden concentrated around diagnosis, highlighting broader, system-level implications for health care spending.<\/jats:p>","DOI":"10.1177\/10775587261486590","type":"journal-article","created":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T11:06:13Z","timestamp":1791457573000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Health Care Expenditures and Cost-Sharing Before and After Long COVID: Three-Year Evidence From a Statewide Multi-Payer Cohort"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8062-9647","authenticated-orcid":false,"given":"Rick","family":"DeVoss","sequence":"first","affiliation":[{"name":"University of Colorado Anschutz, Aurora, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8664-9606","authenticated-orcid":false,"given":"Elizabeth J.","family":"Carlton","sequence":"additional","affiliation":[{"name":"University of Colorado Anschutz, Aurora, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3355-3720","authenticated-orcid":false,"given":"Marcelo C.","family":"Perraillon","sequence":"additional","affiliation":[{"name":"University of Colorado Anschutz, Aurora, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,10,8]]},"reference":[{"key":"e_1_3_4_2_1","unstructured":"Agency for Healthcare Research and Quality. (2023). Social determinants of health database. https:\/\/www.ahrq.gov\/sdoh\/data-analytics\/sdoh-data.html"},{"key":"e_1_3_4_3_1","doi-asserted-by":"crossref","unstructured":"Al-Aly Z. Davis H. McCorkell L. Soares L. Wulf-Hanson S. Iwasaki A. Topol E. J. (2024). Long COVID science research and policy. Nature Medicine 30 2148\u20132164. https:\/\/doi.org\/10.1038\/s41591-024-03173-6","DOI":"10.1038\/s41591-024-03173-6"},{"key":"e_1_3_4_4_1","doi-asserted-by":"crossref","unstructured":"Au L. Capotescu C. Eyal G. Finestone G. (2022). Long covid and medical gaslighting: Dismissal delayed diagnosis and deferred treatment. SSM Qual Res Health 2 Article 100167. https:\/\/doi.org\/10.1016\/j.ssmqr.2022.100167","DOI":"10.1016\/j.ssmqr.2022.100167"},{"key":"e_1_3_4_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/biomet\/87.2.329"},{"key":"e_1_3_4_6_1","doi-asserted-by":"crossref","unstructured":"Basu A. Manning W. G. (2010). Estimating lifetime or episode-of-illness costs under censoring. Health Economics 19(9) 1010\u20131028. https:\/\/doi.org\/https:\/\/doi.org\/10.1002\/hec.1640","DOI":"10.1002\/hec.1640"},{"key":"e_1_3_4_7_1","doi-asserted-by":"crossref","unstructured":"Bebo B. Cintina I. LaRocca N. Ritter L. Talente B. Hartung D. Ngorsuraches S. Wallin M. Yang G. (2022). Economic burden of multiple sclerosis in the United States: Estimate of direct and indirect costs. Neurology 98 e1810\u2013e1817. https:\/\/doi.org\/10.1212\/WNL.0000000000200150","DOI":"10.1212\/WNL.0000000000200150"},{"key":"e_1_3_4_8_1","unstructured":"Center for Improving Value in Healthcare. (2026a). CO APCD insights dashboard. https:\/\/civhc.org\/get-data\/whats-in-the-co-apcd\/"},{"key":"e_1_3_4_9_1","unstructured":"Center for Improving Value in Healthcare. (2026b). Data submission guide version 17. https:\/\/civhc.org\/wp-content\/uploads\/2025\/12\/Data-Submission-Guide-DSG-v17-Final.pdf"},{"key":"e_1_3_4_10_1","unstructured":"Centers for Medicare & Medicaid Services. (2024). Unwinding and returning to regular operations after COVID-19. https:\/\/www.medicaid.gov\/resources-for-states\/coronavirus-disease-2019-covid-19\/unwinding-and-returning-regular-operations-after-covid-19"},{"key":"e_1_3_4_11_1","doi-asserted-by":"crossref","unstructured":"Datta B. K. Coughlin S. S. Fazlul I. Pandey A. (2024). COVID-19 and health care-related financial toxicity in the United States: Evidence from the 2022 National Health Interview Survey. American Journal of Infection Control 52(4) 392\u2013399. https:\/\/doi.org\/10.1016\/j.ajic.2023.11.004","DOI":"10.1016\/j.ajic.2023.11.004"},{"key":"e_1_3_4_12_1","doi-asserted-by":"crossref","unstructured":"DeMartino J. K. Swallow E. Goldschmidt D. Yang K. Viola M. Radtke T. Kirson N. (2022). Direct health care costs associated with COVID-19 in the United States. Journal of Managed Care & Specialty Pharmacy 28(9) 936\u2013947. https:\/\/doi.org\/10.18553\/jmcp.2022.22050","DOI":"10.18553\/jmcp.2022.22050"},{"key":"e_1_3_4_13_1","unstructured":"DeVoss R. (2025). Cost-sharing. https:\/\/github.com\/devor5\/Cost-Sharing"},{"key":"e_1_3_4_14_1","doi-asserted-by":"crossref","unstructured":"DeVoss R. Carlton E. J. Jolley S. E. Perraillon M. C. (2025). Healthcare utilization patterns before and after a long COVID diagnosis: A case-control study. BMC Public Health 25(1) Article 514. https:\/\/doi.org\/10.1186\/s12889-025-21393-4","DOI":"10.1186\/s12889-025-21393-4"},{"key":"e_1_3_4_15_1","doi-asserted-by":"crossref","unstructured":"Duru E. E. Okoye G. Lee S. Weir P. Kim J. (2026). Comparison of healthcare expenditures among individuals with and without long COVID in the United States. INQUIRY: The Journal of Health Care Organization Provision and Financing 63 Article 410890. https:\/\/doi.org\/10.1177\/00469580251410890","DOI":"10.1177\/00469580251410890"},{"key":"e_1_3_4_16_1","doi-asserted-by":"crossref","unstructured":"Fishman P. A. White L. Ingraham B. Park S. Larson E. B. Crane P. Coe N. B. (2020). Health care costs of Alzheimer\u2019s and related dementias within a Medicare managed care provider. Medical Care 58(9) 833\u2013841. https:\/\/doi.org\/10.1097\/mlr.0000000000001380","DOI":"10.1097\/MLR.0000000000001380"},{"key":"e_1_3_4_17_1","doi-asserted-by":"crossref","unstructured":"Greenhalgh T. Sivan M. Perlowski A. Nikolich J. \u017d. (2024). Long COVID: A clinical update. The Lancet 404(10453) 707\u2013724. https:\/\/doi.org\/10.1016\/S0140-6736(24)01136-X","DOI":"10.1016\/S0140-6736(24)01136-X"},{"key":"e_1_3_4_18_1","doi-asserted-by":"crossref","unstructured":"Hoffman G. J. Maust D. T. Harris M. Ha J. Davis M. A. (2022). Medicare spending associated with a dementia diagnosis among older adults. Journal of the American Geriatrics Society 70(9) 2592\u20132601. https:\/\/doi.org\/https:\/\/doi.org\/10.1111\/jgs.17835","DOI":"10.1111\/jgs.17835"},{"key":"e_1_3_4_19_1","doi-asserted-by":"crossref","unstructured":"Koumpias A. M. Schwartzman D. Fleming O. (2022). Long-haul COVID: Healthcare utilization and medical expenditures 6 months post-diagnosis. Bmc Health Services Research 22(1) Article 1010. https:\/\/doi.org\/10.1186\/s12913-022-08387-3","DOI":"10.1186\/s12913-022-08387-3"},{"key":"e_1_3_4_20_1","doi-asserted-by":"crossref","unstructured":"\u0141ukomska E. Kloc K. Kowalska M. Matjaszek A. Joshi K. Scholz S. Van de Velde N. Beck E. (2025). Healthcare resource utilization (HCRU) and direct medical costs associated with long COVID or post-COVID-19 conditions: Findings from a literature review. Journal of Market Access & Health Policy 13(1) Article 7. https:\/\/doi.org\/10.3390\/jmahp13010007","DOI":"10.3390\/jmahp13010007"},{"key":"e_1_3_4_21_1","doi-asserted-by":"crossref","unstructured":"National Academies of Sciences Engineering and Medicine. (2024). A long COVID definition: A chronic systemic disease state with profound consequences. The National Academies Press. https:\/\/doi.org\/doi:10.17226\/27768","DOI":"10.17226\/27768"},{"key":"e_1_3_4_22_1","unstructured":"National Center for Health Statistics. (2024). Household pulse survey: Long COVID. https:\/\/www.cdc.gov\/nchs\/covid19\/pulse\/long-covid.htm"},{"key":"e_1_3_4_23_1","unstructured":"National Center for Immunization and Respiratory Diseases. (2025). Updates to COVID-19 vaccine effectiveness. https:\/\/www.cdc.gov\/acip\/downloads\/slides-2025-06-25-26\/03-MacNeil-COVID-508.pdf"},{"key":"e_1_3_4_24_1","doi-asserted-by":"publisher","DOI":"10.3390\/healthcare13212704"},{"key":"e_1_3_4_25_1","doi-asserted-by":"crossref","unstructured":"Park K. T. Ehrlich O. G. Allen J. I. Meadows P. Szigethy E. M. Henrichsen K. Kim S. C. Lawton R. C. Murphy S. M. Regueiro M. Rubin D. T. Engel-Nitz N. M. Heller C. A. (2019). The cost of inflammatory bowel disease: An initiative from the Crohn\u2019s & Colitis Foundation. Inflammatory Bowel Diseases 26(1) 1\u201310. https:\/\/doi.org\/10.1093\/ibd\/izz104","DOI":"10.1093\/ibd\/izz104"},{"key":"e_1_3_4_26_1","doi-asserted-by":"crossref","unstructured":"Parker E. D. Lin J. Mahoney T. Ume N. Yang G. Gabbay R. A. ElSayed N. A. Bannuru R. R. (2024). Economic costs of diabetes in the U.S. in 2022. Diabetes Care 47(1) 26\u201343. https:\/\/doi.org\/10.2337\/dci23-0085","DOI":"10.2337\/dci23-0085"},{"key":"e_1_3_4_27_1","doi-asserted-by":"crossref","unstructured":"Peluso M. J. Deeks S. G. (2024). Mechanisms of long COVID and the path toward therapeutics. Cell 187(20) 5500\u20135529. https:\/\/doi.org\/10.1016\/j.cell.2024.07.054","DOI":"10.1016\/j.cell.2024.07.054"},{"key":"e_1_3_4_28_1","doi-asserted-by":"crossref","unstructured":"Pike J. Kompaniyets L. Lindley M. C. Saydah S. Miller G. (2023). Direct medical costs associated with Post-COVID-19 conditions among privately insured children and adults. Preventing Chronic Disease 20 Article E06. https:\/\/doi.org\/10.5888\/pcd20.220292","DOI":"10.5888\/pcd20.220292"},{"key":"e_1_3_4_29_1","doi-asserted-by":"crossref","unstructured":"Rahmati M. Udeh R. Kang J. Dolja-Gore X. McEvoy M. Kazemi A. Soysal P. Smith L. Kenna T. Fond G. Boussat B. Nguyen D. C. Do H. Tran B. X. Veronese N. Yon D. K. Boyer L. (2025). Long-term sequelae of COVID-19: A systematic review and meta-analysis of symptoms 3 years post-SARS-CoV-2 infection. Journal of Medical Virology 97(6) Article e70429. https:\/\/doi.org\/10.1002\/jmv.70429","DOI":"10.1002\/jmv.70429"},{"key":"e_1_3_4_30_1","doi-asserted-by":"crossref","unstructured":"Schubart J. R. Schaefer E. W. Knight D. R. T. Mills S. E. Francomano C. A. (2024). Estimates of the excess cost burden of Ehlers-Danlos syndromes: A United States MarketScan\u00ae claims database analysis. Frontiers in Public Health Volume 12 Article 1365712. https:\/\/doi.org\/10.3389\/fpubh.2024.1365712","DOI":"10.3389\/fpubh.2024.1365712"},{"key":"e_1_3_4_31_1","doi-asserted-by":"crossref","unstructured":"Shrestha S. S. Zhang P. Hora I. A. Gregg E. W. (2019). Trajectory of excess medical expenditures 10 years before and after diabetes diagnosis among U.S. adults aged 25\u201364 years 2001\u20132013. Diabetes Care 42(1) 62\u201368. https:\/\/doi.org\/10.2337\/dc17-2683","DOI":"10.2337\/dc17-2683"},{"key":"e_1_3_4_32_1","unstructured":"U.S. Department of Labor. (n.d.). ERISA. https:\/\/www.dol.gov\/general\/topic\/health-plans\/erisa"},{"key":"e_1_3_4_33_1","doi-asserted-by":"crossref","unstructured":"Valdez A. R. Hancock E. E. Adebayo S. Kiernicki D. J. Proskauer D. Attewell J. R. Bateman L. DeMaria A. Lapp C. W. Rowe P. C. Proskauer C. (2019). Estimating prevalence demographics and costs of ME\/CFS using large scale medical claims data and machine learning. Frontiers in Pediatrics 6 Article e00412. https:\/\/doi.org\/10.3389\/fped.2018.00412","DOI":"10.3389\/fped.2018.00412"},{"key":"e_1_3_4_34_1","doi-asserted-by":"crossref","unstructured":"Woodrow M. Carey C. Ziauddeen N. Thomas R. Akrami A. Lutje V. Greenwood D. C. Alwan N. A. (2023). Systematic Review of the Prevalence of Long COVID. Open Forum Infectious Diseases 10(7) Article ofad233. https:\/\/doi.org\/10.1093\/ofid\/ofad233","DOI":"10.1093\/ofid\/ofad233"},{"key":"e_1_3_4_35_1","doi-asserted-by":"crossref","unstructured":"Xie Y. Choi T. Al-Aly Z. (2024). Postacute sequelae of SARS-CoV-2 infection in the pre-delta delta and omicron eras. New England Journal of Medicine 391(6) 515\u2013525. https:\/\/doi.org\/10.1056\/NEJMoa2403211","DOI":"10.1056\/NEJMoa2403211"}],"container-title":["Medical Care Research and Review"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10775587261486590","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/10775587261486590","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10775587261486590","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T16:56:11Z","timestamp":1791737771000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/10775587261486590"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,8]]},"references-count":34,"alternative-id":["10.1177\/10775587261486590"],"URL":"https:\/\/doi.org\/10.1177\/10775587261486590","relation":{},"ISSN":["1077-5587","1552-6801"],"issn-type":[{"value":"1077-5587","type":"print"},{"value":"1552-6801","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,8]]},"article-number":"10775587261486590"}}