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

View Policy Brief

01/2025

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.

ETSU/NORC Rural Health Research Center

Alana Knudson, Craig Holden, Marilyn Klug, Tricia Stauffer, Shena Popat

Emergency medical services (EMS) and trauma, Emergency preparedness and response, Healthcare access, Medicare