OBJECTIVES: Our objective was to quantify changes in RPM utilization among Medicare beneficiaries by rural/urban status and race/ethnicity before and during the COVID-19 pandemic in the US.

METHODS: Medicare beneficiaries enrolled in Part A and Part B were identified (2018-2020). Outpatient claims were used to assess receipt of RPM services. We calculated monthly rates of beneficiaries with RPM utilization per 100,000 beneficiaries enrolled during the month (RPM users) stratified by rural/urban status and race/ethnicity [i.e., non-Hispanic White (NHW) vs. non-NHW]. We fit two interrupted time series models to delineate differences in level and trend between beneficiaries with differing rural/urban status and race/ethnicity using March 2020, the declaration of the COVID-19 public health emergency (PHE) in the US, as interruption time.

RESULTS: RPM users increased from 2 to 240 from January 2018 – December 2020. Trend among urban beneficiaries and non-NHW beneficiaries increased by 3.18 and 4.24 RPM users per month (p<0.0001 for both) prior to the PHE. These populations experienced a level change of 40.72 and 50.57 (p<0.0001 for both) RPM users at the start of the PHE (i.e., March 2020). The change in trend of RPM users per month was significantly different before and after the start of the PHE [i.e., a 16.05 and 23.85 monthly increase for urban beneficiaries and non-NHW beneficiaries, respectively (p<0.0001 for both)]. After the start of the PHE, urban beneficiaries experienced a level change of 24.20 RPM users relative to rural beneficiaries (p=0.0243). The difference in trend for urban vs. rural beneficiaries and non-NHW vs. NHW significantly increased by 7.84 and 11.66 RPM users per month, respectively, before and after the start of the PHE (p<0.0001 for both).

CONCLUSIONS: