Health-related social needs increased for Medicare and Medicaid beneficiaries during the pandemic

Background and goal: Efforts to address the health-related social needs (HRSN) of Medicare and Medicaid beneficiaries, such as housing and food, during the COVID-19 pandemic were insufficient. This research examined HRSN data from the Accountable Health Communities (AHC) study collected in Oregon to understand changes in HRSN for Medicare and Medicaid beneficiaries at the onset and during the first two years of the pandemic.

Study approach: The study sample included 21,522 Medicare and Medicaid beneficiaries screened for overall health-related social needs between May 13, 2019 and December 24, 2021. An interrupted time series analysis was used to analyze both the immediate effects and the long-term trend changes in Medicare and Medicaid beneficiary-reported HRSN following Oregon's stay-at-home order.

Main results: A total of 21,522 unique Medicare and Medicaid beneficiaries participated in AHC in Oregon between May 13, 2019 and December 24, 2021: 8,234 before the March 23, 2020 stay-at-home order, and 13,288 following the order. 

• There was an abrupt 17.7 percentage point increase in overall health-related social needs around March 23, 2020 (onset of stay-at-home order) which did not significantly decline during the study period.
• The percentage of beneficiaries reporting food, housing, and interpersonal safety needs increased by 16.5, 15.9, and 4.4 percentage points, respectively, with no significant decline during the study period.
• The percentage of beneficiaries reporting transportation and utility needs increased by 7.5 and 7.2 percentage points, respectively, but decreased significantly after the start of the pandemic. 

Why it matters: The jump in the number of people reporting health-related social needs following the start of the pandemic and the persistence of needs, particularly in housing, point to a need for increased understanding of which public health and health care interventions, investments, and policies effectively address health-related social needs.