Prior to 1994, Medicare information on race in the Medicare administrative data was limited to the four categories: white, black other and unknown. Subsequently, the Social Security Administration and the Health Care Financing Administration (HCFA), in compliance with OMB Circular 15 began using 6 race codes: white; black; Hispanic; Asian, Asian American or Pacific Islander; Native American or Alaskan Native; unknown. HCFA's attempts to reclassify Medicare beneficiaries will be described. Between 1994 and 1997 this resulted in major increases in the number of beneficiaries identified as Hispanic (a 339% increase), Asian (a 307% increase), and or Native American (a 193% increase). By the time of the APHA Conference data will be available for 1999, and will be presented. Even with these increases, comparison of the race value in the administrative data with self-reported race in the Medicare Current Beneficiary Survey indicates inadequate sensitivity, specificity and positive predictive values for these latter three race groups. In contradistinction, the race values white and black are sufficiently valid and can continue to be used along with other variables to describe and explain disparities in the use of Medicare reimbursed services.
Learning Objectives: At the conclusion of the session, the participant will be able to : 1. explain the strengths and limitations of the race and related variables in the Medicare administrative claims data for understanding access to, and the use of, health services; and 2. identify ways in which information on race can be used in research about Medicare beneficiaries; and
Keywords: Medicare, Health Care Access
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.