Differences in Lyme Disease Diagnosis among Medicaid and Medicare Beneficiaries, United States, 2016-2021

Lyme disease is the most common vectorborne disease in the United States. Evidence suggests that persons from racial and ethnic minority groups experience more severe disease. We used a claims-based algorithm on data from 16 jurisdictions with high Lyme disease incidence to identify cases among 4 populations: Medicaid beneficiaries <18 and >19 years of age, and Medicare fee-for-service beneficiaries <65 and >65 years of age. We calculated the prevalence of disseminated disease, hospitalization, and other clinical and epidemiologic parameters by race and ethnicity. We found that non-White persons were more likely than White persons to be female, hospitalized at diagnosis, diagnosed outside of primary care, diagnosed outside of the peak months for Lyme disease transmission, and have disseminated disease. Those data illustrate differences in Lyme disease by race and ethnicity and suggest possible differences across other sociodemographic characteristics. Additional prevention methods are needed to reduce differences in Lyme disease recognition and severity.