Several surveys conducted during the COVID-19 pandemic showed that adults delayed or skipped health care services during the initial months of the COVID-19 pandemic. To understand changes in health care utilization for rural residents versus non-rural residents during the COVID-19 pandemic, the Rural Health Equity Research Center will analyze the use of primary and preventive care visits and elective procedures in Medicare Fee-For-Service claims prior to and during the COVID-19 pandemic.

We will examine if Medicare fee-for-service enrollees who had an Annual Wellness visit or sought ambulatory care for their chronic conditions continued to access ambulatory care visits, skipped visits, or did not resume usual care. This paired time series analysis will also investigate how Medicare enrollees resumed care after COVID-19 vaccines were available without the confusion added by including patients who did not have an Annual Wellness visit or visits treating the specific conditions during the pre-COVID-19 period, and reduce error variance by studying the same patients over time. In addition, we will examine if telehealth played a role in bridging access to care during the post-COVID period. Comparisons will be adjusted by Medicare enrollees' demographics of race/ethnicity, sex, age, dual enrollment status, and broadband access (using the new FCC data scheduled to be released September 2022).