Did you know that Medicare is not just an insurance program for those 65 years and older? It also serves additional functions by virtue of its population-wide coverage for those who are blind, disabled, or have end-stage kidney disease. Medicare’s vast source of data on beneficiary healthcare utilization and costs, clinical conditions, and medication use is capable of serving a greater purpose such as the COVID-19 vaccination campaign.
CMS’s history of helping
In 2009, CMS data supported the response to the 2009 novel influenza A (H1N1) pandemic. Now, Medicare data is serving the COVID-19 vaccination campaign. On October 2, 2020, the National Academy of Medicine (NAM) released a prioritization scheme it had developed, at the request of the National Institutes of Health and the Centers for Disease Control and Prevention (CDC), for allocation of a COVID-19 vaccine.
The framework recommends that health care workers receive vaccines first, followed by high risk Americans, such as older individuals and those with certain chronic medical conditions.
Medicare data needed now
According to a JAMA study by Nicole Lurie, MD, MSPH, and Bettina Experton, MD, MPH, “using CMS Medicare fee-for-service claim data on more than 15 million beneficiaries, including 770,000 confirmed COVID-19 cases, as well as CDC Social Vulnerability Index data, a predictive model was developed for COVID-19 hospitalization and death at the individual and local population levels.”
The study went on to say that although the initial goal of this model was to help the National Guard and other military personnel in their support for regions and hospitals affected by COVID-19, this data may also need to be put to domestic use. The researchers warned that “after initial release of the vaccine, sufficient doses will not be available to vaccinate everyone, and risk stratification” is very likely to occur in the U.S. as the vaccine campaign has been on such a fast-track.
The Medicare program is more than an insurance program and a lifeline for many older U.S. residents. Supporting the public health and vaccination needs in the COVID-19 pandemic should be an important program imperative and could serve the U.S. population as a whole.