RISE summarizes recent research on the impact COVID-19 has had on outpatient Medicare fee-for-service claims, mental health, and patients with dementia.

Avalere report examines the drop in Medicare FFS utilization during the COVID-19 lockdown

Health care utilization among Medicare Fee-For-Service (FFS) beneficiaries decreased in the spring of 2020 compared to the spring of 2019, a new Avalere analysis finds.

The report used a 20 percent random sample of Medicare Part A and Part B FFS claims between January 1, 2019 and June 30, 2019, and between January 1, 2020 and June 30, 2020 to examine the nationwide impact of the COVID-19 lockdowns in the spring of 2020 on health care utilization. Analysts assessed Medicare FFS claims volume for hospital inpatient, hospital outpatient, and professional/physician services during the first six months of 2020 compared to the first six months of 2019.

The result: Utilization decreased in the first three months of the pandemic (March, April, and May 2020) compared to the same period in 2019. But the largest dip was in April. Avalere found a 51 percent reduction in outpatient claims and a 42 percent reduction in professional claims in 2020 compared to 2019.

Other findings: Utilization among the white Medicare population decreased more than among the Black or Hispanic populations but the largest decrease was observed among Asian beneficiaries, who account for two percent of the overall Medicare FFS population. The research also reveals a larger decrease in claims for non-duals than for the dual-eligible population.

“The decrease in service utilization could indicate that people missed out on preventive care and postponed care they may have needed to receive, which contributes to compounding concerns in management of chronic and acute care leading to pent up demand in future months in addition to potential health care costs associated with gaps in care,” Avalere researchers said.

KFF updates brief on the impact of the pandemic on Americans’ mental health and substance use

Throughout the COVID-19 pandemic and resulting economic crisis, about four in 10 adults nationwide have reported symptoms of anxiety or depressive disorder–a four-fold increase from pre-pandemic levels, according to the Kaiser Family Foundation (KFF), a nonprofit organization that focuses on national health issues and the role of the United States in global health policy.

Using the latest national survey data, KFF polling and other research, KFF analysts updated a brief that explores what’s known about the pandemic’s impact on people’s mental health and substance use and its implications for Americans well-being. Among the takeaways:

  • Young adults ages 18-24 are about twice as likely as all adults to report new or increased substance use (25 percent vs. 13 percent) or recent suicidal thoughts (26 percent vs. 11 percent)
  • Women are more likely than men to report symptoms of anxiety and/or depressive disorder (47 percent vs. 38 percent)
  • Adults in households that experienced job losses or reduced incomes report higher rates of mental health symptoms than other households (53 percent vs. 32 percent)
  • Essential workers, who work outside their homes where they could be exposed to COVID-19, are also more likely than non-essential workers to report symptoms of anxiety or depressive disorder (42 percent vs. 30 percent), increased or new substance use (25 percent vs. 11 percent), or recent suicidal thoughts (22 percent vs. 8 percent)
  • Non-Hispanic Black adults (48 percent) and Hispanic or Latino adults (46 percent) are more likely to report symptoms of anxiety or depressive disorder than white adults (41 percent)


Study: Americans with dementia are twice as likely to get COVID-19

New research published in the Alzheimer's & Dementia: Journal of the Alzheimer's Association finds that people with dementia have two times the risk of getting COVID-19 and are at higher risk of being hospitalized and dying from it. Black people with dementia are at an even greater risk.

The retrospective case-control study by researchers at Case Western Reserve University analyzed the patient electronic health records (EHR) of nearly 62 million adult and senior patients (over the age of 18) in the United States from the start of the pandemic in February up to August 21, 2020. The research team used de-identified population-level EHR data collected by the IBM Watson Health Explorys from 360 hospitals and 317,000 providers across 50 states, representing 20 percent of the US population.

Among the 15,770 adult and senior patients diagnosed with COVID‐19, 810 of them had dementia including 260 patients with Alzheimer’s Disease, 70 with post‐traumatic dementia, 40 with presenile dementia, 140 with senile dementia, and 170 with vascular dementia.

Researchers found that even adjusting for risk factors for COVID-19, such as living in a nursing home or having conditions like asthma or cardiovascular disease, people with dementia were still twice as likely to get COVID-19. Black people with dementia were nearly three times more likely to have COVID-19 compared to white people, a finding that correlates with the disproportionate rate of hospitalizations and deaths from COVID-19 among Black people.

“These preliminary findings suggest a frightening reality of the vulnerabilities associated with dementia,” Maria Carrillo, Ph.D., Alzheimer’s Association chief science officer, said in the study announcement. “It is critical we develop and implement strategies that strike a balance between keeping people, especially long-term care residents, safe from COVID-19 but also protecting them from health-related harms associated with social isolation.”