Changes in Use of Medicare Home Health Services During COVID-19 and Implications for High-Need, High-Cost Beneficiaries

The study team will evaluate changes in the Medicare home health population, specifically community-entrants, during the pandemic and the implications of these changes specifically for high-need, high-cost (HNHC) beneficiaries and racial and ethnic minorities. The team will use Medicare claims and an OASIS supplement to investigate, relative to prepandemic: how the characteristics of home health users, specifically community-entrants, changed during the COVID-19 pandemic with respect to demographics including race/ethnicity, HNHC status, and types of home health services used; trends in outcome measures such as acute hospitalizations or emergency department observed among community-entrant Medicare beneficiaries using home health services during the COVID-19 pandemic; and the relationship between paid and unpaid caregiver availability and use of home health during COVID-19. This project is part of a body of work examining inequities in home health care as a PAC option, because of a lack of Medicare coverage for home health aides to help with activities of daily living.