Costs and Healthcare Resource Utilization after COVID-19 Hospitalization among US Medicare Patients: a Retrospective Claims Analysis.

AIMS:The objective of this study was to quantify all-cause direct healthcare costs and healthcare resource utilization (HCRU) in the six months before and after COVID-19-associated hospitalization among Medicare fee-for-service (FFS) beneficiaries during the recent Omicron period (March 2023-March 2025). METHODS:This retrospective observational study used 100% Medicare FFS claims data. Beneficiaries aged ≥65 years with a COVID-19 hospitalization between September 2023 and September 2024 and continuous enrollment for six months pre-admission and post-discharge were included. A within-group pre/post design compared mean cumulative per-patient healthcare costs and HCRU during the six-month pre-admission and post-discharge periods, excluding index hospitalization costs. Outcomes were stratified by hospitalization severity and post-discharge care setting. RESULTS:Among 72,053 beneficiaries (mean age 80.8 years; 55.1% female), 96.5% had ≥1 high-risk condition. Mean total healthcare costs increased by $13,808 per patient post-discharge versus pre-admission (p < 0.001), driven primarily by care facility/home health ($8,461) and inpatient ($4,278) costs. Larger increases were observed among patients requiring invasive mechanical ventilation ($21,122), with index stays ≥7 days ($23,223), and those discharged to healthcare facilities ($28,857) (all p < 0.001). Mean total healthcare claims increased by 6.1 per patient and inpatient length of stay by 3.6 days (both p < 0.001). CONCLUSIONS:COVID-19 hospitalization among Medicare FFS beneficiaries is associated with substantial increases in post-discharge healthcare costs and utilization, particularly among patients with greater severity and post-acute care needs. These findings highlight the sustained economic burden of COVID-19 in older adults and underscore the need for targeted post-discharge care strategies.