Author:
Baik Seo H.,Baye Fitsum,McDonald Clement J.
Abstract
AbstractDespite the universal healthcare coverages, racial disparities in healthcare expenditures among senior Medicare beneficiaries exist. A few studies explored how racial disparities in healthcare expenditures changed over past decades and how it affected differently across 4 minoritized races, by type of Medicare and poverty levels. We conducted a longitudinal study of 21 healthcare expenditures from senior Medicare fee-for-service enrollees to determine overall and secular trends in racial disparities in healthcare expenditures between 2007 and 2020, during which the Affordable Care Act (ACA) came into full force and the COVID-19 pandemic had begun. We found important disparities in healthcare expenditures across 4 minoritized races compared to Whites, even after adjusting for possible confounders for such disparities. Disparities between Hispanics/Asians and Whites were much greater than disparities between Blacks and Whites, in all Parts A, B, and D expenditures. This reality has not been sufficiently emphasized in the literature. Importantly, Black-White disparities in total Part B expenditure gradually worsened between 2007 and 2020, and Hispanic-White and Asian-White disparities worsened greatly during that time window. Health planners need to focus on these large disparities and develop methods to shrink them.
Publisher
Springer Science and Business Media LLC
Subject
Public Health, Environmental and Occupational Health,Health Policy,Sociology and Political Science,Anthropology,Health (social science)
Reference54 articles.
1. Cubanski J, Swoope C, Boccuti C, Jacobson G, Casillas G, Griffin S, et al. A primer on Medicare [Internet]. 2015. Available from: http://files.kff.org/attachment/report-a-primer-on-medicare-key-facts-about-the-medicare-program-and-the-people-it-covers. Accessed 24 Aug 2020
2. The Centers for Medicare & Medicaid Services. Medicare monthly enrollment - centers for Medicare & Medicaid services data [Internet]. 2023 [cited 2023 Aug 16]. Available from: https://data.cms.gov/summary-statistics-on-beneficiary-enrollment/medicare-and-medicaid-reports/medicare-monthly-enrollment/data. Accessed 26 Aug 2023.
3. The Henry J. Kaiser Family Foundation. Distribution of Medicare beneficiaries by race/ethnicity [Internet]. 2023 [cited 2023 Aug 16]. Available from: https://www.kff.org/medicare/state-indicator/medicare-beneficiaries-by-raceethnicity. Accessed 16 Aug 2023.
4. Trivedi AN, Zaslavsky AM, Schneider EC, Ayanian JZ. Trends in the quality of care and racial disparities in Medicare managed care. N Engl J Med [Internet]. Massachusetts Medical Society; 2005 [cited 2023 Mar 1];353:692–700. Available from: https://www.nejm.org/doi/full/10.1056/nejmsa051207. Accessed 2023-03-01.
5. Trivedi AN, Zaslavsky AM, Schneider EC, Ayanian JZ. Relationship between quality of care and racial disparities in Medicare health plans. JAMA [Internet]. American Medical Association; 2006 [cited 2023 Mar 1];296:1998–2004. Available from: https://jamanetwork.com/journals/jama/fullarticle/203786. Accessed 2023-03-01.