The Devastating Impact of COVID-19 on Medicare Beneficiaries

It is no secret that COVID-19 took a devastating toll on nursing homes across the country. That said, until now, there has not been enough data to tell the bigger story of its impact on those most affected – the residents – especially during the earlier months of the pandemic.

At a high level, most people understand that nursing home residents were more vulnerable to the virus because of age and other underlying medical conditions often associated with the elderly. However, because nursing homes did not have to provide COVID-19 statistics before May 8, 2020, earlier cases and deaths were either underreported or not reported at all.

The Office of the Inspector General (OIG) developed a multi-part study to obtain access to all nursing home pandemic-related data – including the earlier statistics. Examining this data objectively and in its’ entirety is key to helping the OIG gain a better understanding of the effects of COVID-19 on U.S. nursing homes. This data can also help provide more accurate information about the health disparities between the different populations under their care.

Data Analyzed

The OIG obtained and examined standardized, objective data from Medicare beneficiary claims in nursing homes throughout the U.S. This information provided a deeper look at Medicare beneficiaries who were either diagnosed with COVID-19 or deemed likely to have had the virus.

The remaining studies in this series will look closer at what happened, or what failed to happen, in nursing homes hardest hit by COVID-19. There will also be a further analysis of how nursing homes dealt overall with the many expected and unexpected challenges brought on by the pandemic.

Study Results

In this first segment of the study, the OIG analyzed data involving Medicare beneficiaries that were either diagnosed with, or most likely had, the virus. The study also looks at mortality rates compared to the previous year, as well as the specific impact on different ethnicities.

It is important to understand the severity of the effects COVID-19 had on nursing home residents. The OIG recognizes how understanding these outcomes can help both the OIG and the Centers for Medicare & Medicaid Services (CMS) discover better ways to protect the elderly in nursing homes during a pandemic.

This first report of Medicare beneficiaries in nursing homes across the country reveals that:

• On average, two out of five Medicare beneficiaries in U.S. nursing homes were diagnosed with or likely had COVID-19
• The number of Medicare beneficiary deaths increased by nearly 1,000 more in April 2020 than in April 2019
• The overall mortality rate also increased – by 22 percent in 2020 compared to 17 percent in 2019
• The percentage of Black, Hispanic and Asian Medicare beneficiaries who were diagnosed with or likely had COVID-19 was nearly 50 percent, compared to 41 percent of White Medicare beneficiaries

OIG Conclusions

Additional data analysis of Medicare beneficiaries in nursing homes will include a study of more detailed demographics, including individual conditions of residents and their recommended care needs.

In this report, the OIG recognizes the need to continue examining nursing home outcomes of Medicare beneficiaries throughout the pandemic and beyond. Gaining this insight may help both the OIG and CMS find better ways to manage infectious diseases while protecting nursing home residents and improving their care under similar situations in the future.