(020) Trends in Otolaryngology Medicare Utilization and Spending Across the COVID-19 Era: A National Claims Analysis

Introduction: The COVID-19 pandemic disrupted U.S. healthcare delivery, disproportionately affecting outpatient- and elective-heavy specialties like otolaryngology. This study aimed to characterize the impact of the COVID-19 pandemic on Medicare-related otolaryngology activity and assess post-pandemic recovery.

Methods: We performed a retrospective analysis of national Medicare Part B claims from 2013–2023. Annual otolaryngology claim volume and aggregate Medicare spending were evaluated overall and by setting (facility vs. office). Interrupted time series analyses were used to assess changes at the pandemic onset in 2020 as well as recovery relative to pre-pandemic trends. Otolaryngology utilization and spending were also analyzed as proportions of total Medicare activity.

Results: In the pre-pandemic era (2013–2019), otolaryngology claim volume and expenditure increased modestly year-over-year (+0.08 million claims/yr, p< 0.001; +$6.17 million/yr, p< 0.05, respectively). At the pandemic onset, annual claim volume dropped by 2.7 million (–21%, p< 0.001) and spending declined by $155 million (–22%, p< 0.01). Between 2020–2023, spending rebounded rapidly but fell short of pre-pandemic projections (β₃=+$35.95 million/yr, p< 0.05). Claim volume largely failed to rebound (β₃=+0.04 million/yr, p>0.05). Stratified by setting, facility-based care demonstrated more robust recovery in Medicare utilization and spending than outpatient care. Importantly, otolaryngology’s proportional share of Medicare claim volume declined in 2020 and remained below pre-pandemic trends through 2023; the share of spending recovered to baseline.

Conclusions: Otolaryngology Medicare utilization fell sharply and disproportionately during the COVID-19 pandemic, especially in the outpatient setting. By 2023, utilization remained persistently below pre-pandemic trends despite recovery in aggregate spending. These findings may point to enduring post-COVID gaps in service delivery and shifts in practice patterns, with potential adverse implications for care access, care continuity, and practice sustainability.