OBJECTIVES: The COVID-19 pandemic has underscored the urgency to focus on the essential value of public health systems (PHS) in fostering health equity across the U.S. healthcare delivery system. PHS integration and care coordination can be successfully achieved through Health information technologies (HIT) systems. The objective of the study was to examine the association between public health systems (PHS) partnership and telehealth-post discharge and racial and ethnic disparities in health care.

METHODS: The analysis used 2017 CMS Medicare 100% inpatient claims data, the Medicare Beneficiary Summary File, the American Hospital Annual survey, and the American Community Survey. Our final sample size was 2,142,486, including 1,990,781 White, 151,705 Black, and 74,998 Hispanic community-dwelling Medicare fee-for-service beneficiaries aged 65 years and up who had at least one hospital visit in 2017. Outcome of interests were total Medicare payments, 30-day all cause readmission rate, and the number of inpatient visits.

RESULTS: Compared to those treated in hospitals with neither PHS partnership nor telehealth-post discharge, beneficiaries treated in hospitals with PHS partnership encountered significantly lower Medicare payment, and lower inpatient and readmission rates. Blacks encountered significantly lower cost, inpatient visits, and readmission rates when treated hospitals with PHS partnership + telehealth-post discharge (coefficient=-0.051, p<0.001; IRR=0.982, p=0.007; IRR=0.891, p=0.003).

CONCLUSIONS: Results demonstrated the importance of combing PHS partnership + telehealth-post discharge to improve the efficiency of the health care delivery system and health equity. It is urgent to ensure that PHS have adequate funding and telehealth support given the encouraging findings of our study.