News: Patients with highest risk from COVID-19 received therapy least often, study finds

Patients with the highest risk for severe COVID-19 infection received outpatient therapy less often than those with the least risk, according to a recently published JAMA study. The study analyzed Medicare fee-for-service claims in which the beneficiary had a primary or secondary diagnosis of COVID-19 throughout the calendar year 2022. This diagnosis was signaled by the use of ICD-10-CM code U07.1, COVID-19, JustCoding reported.

Researchers also looked into variables of E/M ambulatory visits in which the primary diagnosis was COVID-19, COVID-19 testing, and outpatient therapies. The outpatient therapies included the administration of oral antivirals nirmatrelvir and molnupiravir, intravenous (IV) remdesivir infusions, and IV monoclonal SARS-CoV-2 antibodies injections and infusions, represented by CPT and HCPCS codes.

Researchers also found noticeable differences in resources given to patients with the highest and lowest risks for COVID-19 hospitalization and mortality. Notably, 4.9% of patients in the highest-risk quintile received treatment for COVID-19 despite 2.5% being hospitalized for it, while 7.5% of patients in the lowest-risk quintile received the same treatment despite only 0.2% being hospitalized for the disease.

“This misallocation of outpatient antiviral therapy contributes to well-recognized disparities in COVID-19 treatment for historically underserved groups like Black and Hispanic beneficiaries, patients dually eligible for Medicare and Medicaid, and rural residents,” the researchers stated. They encourage individual practices and health systems to identify potential barriers to care that their patients may face, especially patients with the highest risk for adverse outcomes from COVID-19.

Editor’s note: To read JustCoding’s coverage of this story, click here. To access the JAMA study, click here.