Catastrophic health claims: 8 things to know

Becker's Healthcare September 30, 2025
Elizabeth Casolo

Catastrophic health events — such as brain injuries and amputations — are life altering for patients, but these claims also weigh on insurers. From rising utilization and medical costs to expanded eligibility for catastrophic health coverage, the role of these claims has become increasingly relevant. 2025’s “Catastrophic Diagnoses Trends Report” from care management organization Paradigm unpacks what insurers should know.

“It is in the interest of the plans to have more of a long-term view of these cases,” Cathy Hartman, Paradigm’s chief healthcare solutions officer, told Becker’s.

Here are eight big takeaways:

1. There is minimal churn for health plan members facing these challenges. A year after their diagnosis, 68% are still on their health plan.

2. The annual...

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