CMS released new Medicare claims data Monday that show those who are older, lower income, minorities and have chronic conditions are at higher risk for COVID-19.
The claims data, which covers Jan. 1 through May 16, reveal that more than 325,000 Medicare beneficiaries (or 518 COVID-19 cases per 100,000 Medicare beneficiaries) were diagnosed with COVID-19, nearly 110,000 of whom were hospitalized for COVID-19-releated treatment.
The most at-risk group among Medicare enrollees was those with end-state renal disease, of which there were 1,341 hospitalizations per 100,000 people. Those with chronic kidney disease and require dialysis often have chronic conditions like diabetes and heart failure that can increase their risk for complications for COVID-19 and are unable to shelter at home because of their treatment needs, CMS said.
Dual-eligible enrollees had both higher infection rates and higher hospitalization rates regardless of age, sex and race/ethnicity. Those enrolled in Medicare and Medicaid had an infection rate of 1,406 cases per 100,000, while Medicare-only beneficiaries comprised 325 cases per 100,000, according to the data. Likewise, dual-eligible enrollees had a hospitalization rate of 473 cases per 100,000—the second highest among all beneficiaries. These patients already tend to have conditions that require a lot of treatment and therefore increase costs to care for them.
Those who identify as Black were hospitalized with COVID-19 nearly four times more often than those who are white and had the highest hospitalization rate among racial and ethic groups, according to the data.
“At the end of the day, it reconfirms longstanding issues around disparities” in health outcomes for racial and ethnic minority groups and those who are low income, CMS Administrator Seema Verma said during a press call.
Verma said the data show the need to focus on value-based care, rather than fee-for-service models that don’t focus on quality of care for patients.
“Our fee-for-service system is consistently showing itself to be insufficient for our most vulnerable Americans,” Verma said.
Medicare has spent $1.9 billion on fee-for-service COVID-19 hospitalizations, or roughly $23,000 per hospitalization, according to CMS.
CMS typically releases Medicare claims data annually but will be releasing a monthly Medicare COVID-19 Snapshot during the pandemic. CMS plans to start sharing Medicaid data soon, as well.