CMS data show high hospitalization rate among patients with ESKD and COVID-19
CMS has released preliminary Medicare claims data that show patients with end-stage renal disease who are diagnosed with COVID-19 had the highest rate of hospitalization among all Medicare beneficiaries.
“Patients with ESRD are also more likely to have chronic comorbidities associated with increased COVID-19 complications and hospitalization, such as diabetes and heart failure,” according to a CMS press release. Data showed 1,341 hospitalizations among patients with ESRD per 100,000 Medicare beneficiaries.
The agency said the data provide an early snapshot of the impact of the COVID-19 pandemic on the Medicare population.
“The data shows that older Americans and those with chronic health conditions are at the highest risk for COVID-19 and confirms long-understood disparities in health outcomes for racial and ethnic minority groups and among low-income populations,” according to the CMS release.
The findings include the total number of reported COVID-19 cases and hospitalizations among Medicare beneficiaries between Jan. 1 and May 16, 2020. CMS reviewed COVID-19 cases and hospitalizations for Medicare beneficiaries by state, race/ethnicity, age, gender, dual eligibility for Medicare and Medicaid, and urban/rural locations. More than 325,000 Medicare beneficiaries had a diagnosis of COVID-19.
“This translates to 518 COVID-19 cases per 100,000 Medicare beneficiaries,” CMS noted. “The data also indicate that nearly 110,000 Medicare beneficiaries were hospitalized for COVID-19-releated treatment, which equals 175 COVID-19 hospitalizations per 100,000 Medicare beneficiaries.”
Black patients were hospitalized with COVID-19 at a rate nearly four times higher than white patients. “The disparities in the data reflect longstanding challenges facing minority communities and low-income older adults, many of whom face structural challenges to their health that go far beyond what is traditionally considered ‘medical’,” CMS Administrator Seema Verma said in a statement. “Now more than ever, it is clear that our fee-for-service system is insufficient for the most vulnerable Americans because it limits payment to what goes on inside a doctor’s office. The transition to a value-based system has never been so urgent.”
Other key data points included the following:
- Among racial/ethnic groups, Black patients had the highest hospitalization rate, with 465 per 100,000 Medicare beneficiaries. Hispanic patients had 258 hospitalizations per 100,000 beneficiaries, and Asian American patients had 187 hospitalizations per 100,000 beneficiaries. White patients had 123 hospitalizations per 100,000 beneficiaries.
- Beneficiaries living in rural areas had fewer cases and were hospitalized at a lower rate than those living in urban/suburban areas (57 vs. 205 hospitalizations per 100,000 Medicare beneficiaries).
The snapshot also showed that besides higher hospitalization rates, beneficiaries enrolled in both Medicaid and Medicare had a higher infection rate of COVID-19, with 1,406 cases per 100,000 beneficiaries. By comparison, the COVID-19 infection rate for beneficiaries enrolled only in Medicare is 325 cases per 100,000 beneficiaries.
The data will be updated on a monthly basis as more claims and encounter records are received, the agency said. CMS anticipates releasing similar information on Medicaid beneficiaries in the future.