Patient Characteristics and Costs Associated With COVID-19-Related Medical Care Among Medicare Fee-for-Service Beneficiaries

Ann Intern Med. 2021 Aug;174(8):1101-1109. doi: 10.7326/M21-1102. Epub 2021 Jun 1.

Abstract

Background: New cases of COVID-19 continue to occur daily in the United States, and the need for medical treatments continues to grow. Knowledge of the direct medical costs of COVID-19 treatments is limited.

Objective: To examine the characteristics of older adults with COVID-19 and their costs for COVID-19-related medical care.

Design: Retrospective observational study.

Setting: Medical claims for Medicare fee-for-service (FFS) beneficiaries.

Patients: Medicare FFS beneficiaries aged 65 years or older who had a COVID-19-related medical encounter during April through December 2020.

Measurements: Patient characteristics and direct medical costs of COVID-19-related hospitalizations and outpatient visits.

Results: Among 28.1 million Medicare FFS beneficiaries, 1 181 127 (4.2%) sought COVID-19-related medical care. Among these patients, 23.0% had an inpatient stay and 4.2% died during hospitalization. The majority of the patients were female (57.0%), non-Hispanic White (79.6%), and residents of an urban county (77.2%). Medicare FFS costs for COVID-19-related medical care were $6.3 billion; 92.6% of costs were for hospitalizations. The mean hospitalization cost was $21 752, and the mean length of stay was 9.2 days; hospitalization cost and length of stay were higher if the patient needed a ventilator ($49 441 and 17.1 days) or died ($32 015 and 11.3 days). The mean cost per outpatient visit was $164. Patients aged 75 years or older were more likely to be hospitalized, but their hospitalizations were associated with lower costs than for younger patients. Male sex and non-White race/ethnicity were associated with higher probability of being hospitalized and higher medical costs.

Limitation: Results are based on Medicare FFS patients.

Conclusion: The COVID-19 pandemic has resulted in substantial disease and economic burden among older Americans, particularly those of non-White race/ethnicity.

Primary funding source: None.

Publication types

  • Observational Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Ambulatory Care / economics*
  • COVID-19 / economics*
  • Direct Service Costs* / trends
  • Fee-for-Service Plans
  • Female
  • Hospital Costs* / trends
  • Hospitalization / economics*
  • Humans
  • Male
  • Medicare / economics*
  • Pandemics
  • Retrospective Studies
  • SARS-CoV-2
  • United States