Racial Disparities Widespread In Medicare System

Amy Norton, Reuters Health, Oct, 24, 2006

Older black adults are less likely than whites to have their blood pressure, cholesterol and blood sugar under control, even if they belong to a high-quality Medicare plan, researchers reported Tuesday.

The findings, published in Wednesday’s Journal of the American Medical Association, show that racial disparities are common throughout the Medicare system.

“This is not a limited problem within a few health plans,” said lead study author Dr. Amal N. Trivedi of Brown University in Providence, Rhode Island. “It’s something they’ll all have to address.”

The extent to which patients have their blood pressure, cholesterol and blood sugar under control is considered a key indicator of health plan quality. Studies have long pointed to health disparities between white and black Americans, but the new research shows that this is not because black Americans are more often stuck in lower-quality health plans.

Of the 151 Medicare health plans Trivedi’s team analyzed, racial disparities were seen within individual plans, including “high-performing” ones where a relatively high percentage of patients had their high blood pressure, cholesterol or blood sugar in check.

Overall, the proportion of African Americans who had these conditions under control was 6.8 to 14.4 percentage points lower compared with whites.

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So it will be important to address the racial gaps this study uncovered, he said. One of the obstacles, Trivedi noted, is that although the federal government requires Medicare plans to report data on overall quality of care, many plans do not collect information on the race and ethnicity of their members.

“So many of these plans may be unaware they have racial disparities,” he said.

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As for why racial disparities exist even within the same health plan, the answer is not clear. The study measured certain demographic factors, like income and education, and these explained only some of the healthcare gap, Trivedi said.

The problem is likely multifaceted, he noted, and may involve factors such as differences in the individual doctors black and white patients see, and differences in diet and other lifestyle habits.

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