On Aug. 30, the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) published a study entitled, “Medicare Beneficiaries Hospitalized With COVID-19 Experienced a Wide Range of Serious, Complex Conditions.” The study was conducted because Medicare beneficiaries have been particularly affected by COVID-19 and remain highly at risk to new variants and the continued surges of the virus.
The report states that “Understanding the types of conditions for which Medicare beneficiaries with COVID-19 are being treated and who was more likely to be hospitalized with COVID-19 can help hospitals and health officials better prepare for and address the wide-ranging and extensive needs of COVID-19 patients, particularly in the event of localized surges of cases. Such knowledge will also assist in the Federal, State, and local response to the pandemic by providing a better picture of the needs of these hospitalized beneficiaries.”
The researchers reviewed hospital inpatient claims and enrollment data to identify Medicare beneficiaries who were hospitalized in a short-term acute-care hospital from April 1, 2020 to July 31, 2020. They then identified six localities that experienced a surge in hospitalizations of Medicare beneficiaries with COVID-19 over a three-week period and analyzed the diagnoses on the claims in the six localities to identify conditions for which they were treated during their hospital stays.
That said, “During surges in hospitalizations, hospitals in the six localities treated Medicare beneficiaries with COVID-19 for a wide range of serious, complex conditions. Almost all of these beneficiaries were treated for acute respiratory issues, such as viral pneumonia. Many of these beneficiaries were also treated for other types of serious conditions including:
- almost half were treated for acute kidney failure,
- almost half had acute circulatory issues,
- almost two-thirds were treated for significant endocrine, nutritional, or metabolic issues, and
- more than one-third had sepsis.
More than 50 percent of Medicare beneficiaries hospitalized with COVID-19 received intensive care or mechanical ventilation. Additionally, dually eligible, Black, Hispanic, or older beneficiaries were disproportionately hospitalized with COVID-19 relative to the Medicare population in these localities.”
The report concludes that the complex needs of hospitalized Medicare beneficiaries combined with surges in hospitalizations may create challenges in meeting the needs these patients, notably due to staffing and other difficulties reported by hospitals. Gaining a better understanding of Medicare beneficiaries hospitalized with COVID-19 can provide added guidance to hospitals, physicians, and other practitioners so they are better prepared for the complex needs of these patients. CMS can also benefit from this information during continued surges of the virus to better identify beneficiaries who are particularly vulnerable to hospitalization, as well as their needs during hospitalization. Medicare claims data can be used to improve the treatment of COVID-19 and help inform additional research efforts.
