At-Home COVID-19 Tests in Low Supply Before New CMS Requirements

In a sample of online retailers, only a fraction of the at-home COVID-19 testing opportunities were available the week before CMS announced the new at-home COVID-19 test coverage requirements for payers, according to a study from Kaiser Family Foundation (KFF).

The researchers observed six retailer websites to assess the availability of ten types of at-home coronavirus tests. According to the full search data, the six online retailers were Walmart, Target, CVS Health, Walgreens, Amazon, and Kroger. The at-home tests included brands such as Abbott BinaxNow, OraSure InteliSwab, and Ellume COVID19 Home Test.

The analysis lasted from January 3, 2022 through January 10, 2022, ending the day before CMS announced that it would require payers to cover at-home coronavirus testing starting on January 15, 2022.

In all eight days, between ten types of tests and six online retailers, there were 480 possible opportunities for purchase through these channels, representing 100 percent of the available testing opportunities in the study. For example, the option to purchase one ihealth test packet from Amazon on January 3, 2022 would count as a single possible opportunity.

However, over the course of eight days, only 43 testing opportunities were actually available. That is, nine percent of all testing opportunities were actually available and 91 percent of all possible tests were unavailable (437 tests).

If an opportunity was not available, that categorization could mean one of two things. Either the retailer had the item on their website but it was listed as “out of stock” or it could mean that the retailer did not offer the brand of at-home coronavirus testing kits online. 

Four of the brands were never available over the course of the study. Additionally, three of the online retailers never had tests available, either because they were out of stock or they were not selling the brand.

The researchers also looked at prices for the tests. Since one of the main drivers behind the new requirement that payers have to cover at-home coronavirus testing was the fact that cost could be a barrier to accessing tests, this metric was weighty. 

The at-home coronavirus tests from the ten brands in the study had a fairly broad range in terms of pricing. At the low end, one pack of two at-home tests could cost $17.98. Seven of the 480 possible opportunities had this sticker price. On the higher end of the cost scale, there were five possible opportunities for consumers to purchase a product with one test in it for $49.99.

The most common price, however, was $24.88. There were nine possible opportunities over the study timeframe for consumers to buy a test packet for this amount.

“Overall, we find that despite efforts to increase test production by manufacturers and the administration, test availability remains limited,” the researchers explained. “Continued challenges with home test availability could limit the reach of the new reimbursement policy and if the policy drives additional demand for these tests, could exacerbate the problem.”

However, the outlook was not completely hopeless.

“As more tests are authorized and production hopefully ramps up, shortages may ease,” the researchers projected.

When CMS announced that payers would be required to cover at-home coronavirus testing, payers voiced support but expressed concerns about the at-home coronavirus testing supply. Some payer experts feared that this could fuel tensions between consumers and payers, further damaging members' already fragile trust in the insurance industry.

The new requirement was not completely unexpected. In December 2021, the Biden administration released its coronavirus testing coverage plan. That announcement stated that by January 15, 2022 the Departments of Health and Human Services, Labor, and the Treasure would release guidance around at-home coronavirus testing coverage.

Prior to this, the administration spent more than $3 billion on rapid test and at-home test production in September 2021.

Although the Biden administration directed the relevant departments to shape the guidance in early December, payers had concerns about setting up the procedures needed to address the public’s coronavirus testing coverage demands in four days when CMS released the guidance on January 11, 2022.