Telehealth Disparities Under COVID-19 Pandemic for American Indian/Alaskan Native and African-American People
Health and telehealth disparities for American Indian/Alaskan Native and African-American People are continuously accentuated under the COVID-19 pandemic.
The Centers for Medicare and Medicaid Services (CMS) has traditionally released information on Medicare claims annually, but because of the COVID-19 pandemic, the agency began releasing information on June 22, 2020, to allow the public to have critical data on the effect that COVID-19 is having on Medicare beneficiaries. The data released showed the impact of COVID-19 health and telehealth disparities by state, race/ethnicity, age, gender, location (urban or rural), and by dual eligibility for Medicare and Medicaid.
The first monthly update of that information was released on July 28, 2020, by the Centers for Medicare and Medicaid Services (CMS). That data covers the period of January 1, 2020, through June 20, 2020, and includes information unraveling health and telehealth disparities on the American Indian /Alaskan Native Medicare population which had not been previously reported. The data shows that:
- American Indian/Alaskan Native people have a high rate of hospitalization for COVID-19, second only to
- African-American people who have been hospitalized at rates higher than other racial or ethnic groups.
Prior to this CMS analysis, the number of hospitalizations for American Indian and Alaska Native beneficiaries was so low that it was not reported. The COVID-19 public health emergency then is inordinately affecting racial and ethnic minority groups highlighting health and telehealth disparities. These people have typically higher rates of chronic health problems and social determinants impacting health.
In response to the first data reported, CMS director Verma Seema issued a Call to Action. The CMS Office of Minority Health held three sessions with entities who interact with racial and ethnic minority Medicare beneficiaries to understand how CMS can positively impact barriers to healthcare, thereby lessening disparities. Information from the data provides several insights:
1. African-American beneficiaries are hospitalized at greater rates than other racial and ethnic groups (670 hospitalizations per 100,000 beneficiaries).
2. Beneficiaries who are eligible for both Medicaid and Medicare claims have a significantly higher infection rate of COVID-19, tend to suffer from chronic health conditions and have low incomes. This group was found to be hospitalized 4.5 times more than beneficiaries with Medicare only.
3. Medicare beneficiaries with end-stage renal disease are hospitalized at higher rates than any other category of Medicare beneficiaries and have comorbidities that predispose them to increased COVID -19 complications.
4. CMS has paid an average of $25,255 per beneficiary for COVID-19 related hospitalizations.
In the June 26, 2020 words of Mathew, Brian and Walter Clair, “Unless it’s done carefully, the rise of telehealth could widen health disparities.”