• Yuping Tsai, Tara M Vogt, and Fangjun Zhou.
• National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia (Y.T., T.M.V., F.Z.).
• Ann. Intern. Med. 2021 Aug 1; 174 (8): 1101-1109.

BackgroundNew cases of COVID-19 continue to occur daily in the United States, and the need for medical treatments continues to grow. Knowledge of the direct medical costs of COVID-19 treatments is limited.ObjectiveTo examine the characteristics of older adults with COVID-19 and their costs for COVID-19-related medical care.DesignRetrospective observational study.SettingMedical claims for Medicare fee-for-service (FFS) beneficiaries.PatientsMedicare FFS beneficiaries aged 65 years or older who had a COVID-19-related medical encounter during April through December 2020.MeasurementsPatient characteristics and direct medical costs of COVID-19-related hospitalizations and outpatient visits.ResultsAmong 28.1 million Medicare FFS beneficiaries, 1 181 127 (4.2%) sought COVID-19-related medical care. Among these patients, 23.0% had an inpatient stay and 4.2% died during hospitalization. The majority of the patients were female (57.0%), non-Hispanic White (79.6%), and residents of an urban county (77.2%). Medicare FFS costs for COVID-19-related medical care were $6.3 billion; 92.6% of costs were for hospitalizations. The mean hospitalization cost was $21 752, and the mean length of stay was 9.2 days; hospitalization cost and length of stay were higher if the patient needed a ventilator ($49 441 and 17.1 days) or died ($32 015 and 11.3 days). The mean cost per outpatient visit was $164. Patients aged 75 years or older were more likely to be hospitalized, but their hospitalizations were associated with lower costs than for younger patients. Male sex and non-White race/ethnicity were associated with higher probability of being hospitalized and higher medical costs.LimitationResults are based on Medicare FFS patients.ConclusionThe COVID-19 pandemic has resulted in substantial disease and economic burden among older Americans, particularly those of non-White race/ethnicity.Primary Funding SourceNone.

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