Studies of access to care under Medicare fee-for-service (FFS) show racially based inequalities. Health care coverages provided by Medicare health maintenance organization (HMO) plans appear to address some of the barriers to access documented under the FFS system. National data from the 1997 Medicare Current Beneficiary Survey show White and Black beneficiaries enrolling in Medicare HMOs at comparable rates, with Hispanic beneficiaries showing greater enrollment. However, national estimates may obscure important interactions between population distribution and HMO penetration. Using the 1996 Medicare Denominator data for Florida we determined HMO enrollment for each elderly Florida beneficiary. Rates for race/ethnic subgroups were calculated for each county and aggregated into ‘large' metropolitan statistical area (MSA), ‘small' MSA, and rural (i.e., non-MSA) groups. Overall, Blacks had substantially higher rates of enrollment than Whites. However, enrollment rates varied by MSA grouping. Enrollment differences were pronounced in large MSAs (44% versus 27% for Blacks and Whites), but not in smaller MSAs (10% versus 7%) and rural areas (2% versus 3%). When the four counties with the majority (83%) of Hispanic beneficiaries were examined, HMO enrollment for Whites and Hispanics were comparable (32% versus 31%) and well below that for Blacks (52%). Thus, national data does not adequately reflect race/ethnic differences in rates of Medicare HMO enrollment. In large urban areas, Blacks appear much more likely than Whites or Hispanics to enroll in Medicare HMOs. Examination of the factors affecting Medicare HMO enrollment requires attention to the characteristics of the specific areas in which beneficiaries live.
Learning Objectives: At the conclusion of the session, participants in this session will be able to:
Keywords: Medicare, Managed Care
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.