Health disparities among aged Hispanic Medicare beneficiaries: The current perspective

This study assessed the extent to which health disparities exist among aged Hispanic Medicare beneficiaries by race/ethnicity, socioeconomic status (SES), and geographic location in the United States. It involved two research contracts that sought to improve the race/ethnicity and SES categorization of Medicare beneficiaries. After assessing the current race/ethnicity data from the Medicare enrollment database (EDB), the first contract developed an algorithm using language preference, surname, and geographic location to improve race/ethnicity coding for Hispanics. After validating the algorithm, it was applied to the entire 41.7 million Medicare beneficiaries. The second contract created and validated a measure for SES. The top 10 metropolitan statistical areas (MSAs) with the largest number of Hispanics 65 years of age or older were also examined. Medicare administrative claims data (2002) were used to measure the use of services for various cancer screenings and secondary prevention of diabetes complications. The population (a probability sample of 1.96 million Medicare beneficiaries from the mid-2003 unloaded EDB) included: whites, African Americans, Hispanics, Asian/Pacific Islanders, and American Indian/Alaskan Natives enrolled in fee-for-service Medicare.

Our research found that improving the race/ethnicity and SES categorization of Medicare beneficiaries allowed for the assessment of health disparities between white and Hispanic Medicare beneficiaries. The percent of whites receiving cancer screenings and secondary prevention of diabetes complications were then used to compare the percent for Hispanics nationwide and in the top 10 MSAs for Hispanics. Key MSA findings include: in Miami, FL, Hispanics were half as likely to receive any type of colorectal screenings compared to whites (11 percent compared to 22 percent, respectively). In San Antonio, TX, Hispanics diagnosed with diabetes were significantly less likely to receive an eye exam compared to whites (55 percent compared to 72 percent, respectively). Based on our analysis, we found health disparities between white and Hispanic Medicare beneficiaries exist in the 10 MSAs where the highest percentage of aged Hispanics reside.

This research provides us with a better understanding of disparities faced by aged Hispanics in specific MSAs, which may help federal and state agencies target resources to specific areas more efficiently and allow localities to develop interventions that best meet the needs of their residents.

This work was performed by the Research Triangle Institute (RTI) for CMS and AHRQ under CMS Contract Number: 500-00-0024, Task No. 8 (2005), and an AHRQ/CMS Interagency Agreement, CMS Contract Number 500-00-0024 Task No. 21 (2006).