Medical expenses similar for white, black, hispanic Medicare seniors

Black, white and Hispanic seniors who receive Medicare spend similar amounts on medical care each year, according to a new study in the Milbank Quarterly.

The small differences that exist "mainly reflect differences in medical need," according to Jos� J. Escarce, M.D., Ph.D., and Kanika Kapur, Ph.D., of the RAND Health Program.

"Our study offers evidence that racial and ethnic differences in medical care expenditures among older persons in the United States are small if they exist at all," Escarce and Kapur say.

The study concludes that black and Hispanic seniors spend greater amounts of public funds, such as Medicare or Medicaid coverage, on items like prescription medications and home health care. But when socioeconomic status is taken into account as well, the racial and ethnic gap in public expenditures narrows.

This suggests "that public sources of payment for medical care play a crucial role in muting racial and ethnic differences in medical care expenditures among seniors," the researchers say.

Escarce and Kapur analyzed medical care expenses incurred by 4,870 Medicare patients ages 65 and older from 1996 to 1998. While comparing expenses between white, black and Hispanic patients, they determined the degree to which expenditures reflected medical need as well as differences in socioeconomic status and health insurance.

In all cases, there were no significant differences in overall expenses related to race or ethnicity, say the researchers.

Escarce and Kapur also found that white seniors were much more likely than black or Hispanic seniors to consider themselves to be in good health. White seniors were also more likely to have private supplemental insurance and to spend more private insurance or out-of-pocket money on medical care.

The researchers suggest that recent policy changes, including public coverage's availability to more low-income seniors and equalization of physicians' payments for treating patients with private and public supplementary insurance, may help minimize the relationship between socioeconomic status and medical care among Medicare patients.

By Becky Ham, Staff Writer
Health Behavior News Service

For more information:
Health Behavior News Service: 202-387-2829 or http://www.hbns.org.
Interviews: Contact Jos� Escarce at 310-393-0411, ext. 7775 or [email protected]
Milbank Quarterly: Contact Bradford H. Gray, Ph.D., at 212-822-7287.