Impact of the COVID-19 Pandemic on Medical Expenditures among Medicare Fee-For Service Beneficiaries Aged 67 Years or Older With Diabetes

Objective: To compare total and out-of-pocket (OOP) medical expenditures between pre-COVID-19 (03/2019—02/2020) and COVID-19 (03/2020—02/2022) periods among Medicare beneficiaries with diabetes.

Research Design and Methods: Data were from 100% Medicare fee-for-service claims. Diabetes was identified using the International Classification of Disease codes 10th revision. We calculated quarterly total and OOP medical expenditures at population and per capita level in total and by service type. Per capita expenditures were calculated by dividing the population expenditure by the number of beneficiaries with diabetes in the same quarter. Changes in expenditures were calculated as the differences in the same quarters between the pre-pandemic and pandemic years.

Results: Population total expenditure fell to $33.6 billion in the first quarter of the pandemic from $41.7 billion in the same pre-pandemic quarter; it then bounced back to $36.8 billion by fourth quarter of the second pandemic year. The per capita total expenditure fell to $5,356 in the first quarter of the pandemic from $6,500 in the same pre-pandemic quarter. It then increased to $6,096 by the fourth quarter of the second pandemic year, surpassing the same quarter in the pre-pandemic year ($5,982). Both population and per capita OOP expenditures during the pandemic period were lower than the pre-pandemic period. Changes in per capita expenditure between the pre-COVID-19 and COVID-19 periods by service type varied.

Conclusions: COVID-19 had a significant impact on both total and per capita medical expenditures among Medicare beneficiaries with diabetes. The COVID-19 pandemic was associated with a lower OOP expenditures.