Research Alert: January 21, 2025

Examining Differences in Rural and Urban Medicare FFS Beneficiaries' Emergency Department Use Before and During Covid

This brief examines changes in emergency department (ED) use among rural and urban Medicare Fee-for-Service (FFS) beneficiaries before and during the COVID-19 pandemic (2018–2022). Using claims data, researchers identified shifts in care-seeking behavior, admission patterns, and outcomes.

Key Findings:

• During the COVID-19 pandemic, there was an 8% increase in ED use among rural Medicare FFS beneficiaries and an 8.5% increase among their urban counterparts.
• ED use among dual eligibles (Medicare and Medicaid coverage) declined among rural (-6.3%) and urban (-3.3%) beneficiaries.
• ED visits resulting in hospital admissions and deaths significantly increased during COVID-19. Specifically, rural EDs experienced a nearly 30% increase in patient deaths and a 17.2% increase in patients admitted for inpatient hospital care following an ED visit.

Additional Resources of Interest:

• More FORHP-funded research on Medicare
• More information about the ETSU/NORC Rural Health Research Center