Are there racial and ethnic differences in Medicare costs for older adults with dementia?
In an analysis of information on Medicare beneficiaries with dementia, Medicare expenditures were higher for Black and Hispanic individuals compared with whites. The Journal of the American Geriatrics Society analysis also found that expenditures were highest for Black beneficiaries in every phase of care.
The average total Medicare expenditures after being diagnosed with dementia were $165,730 for Black beneficiaries, $160,442 for Hispanic beneficiaries, and $136,326 for white beneficiaries. In the year preceding and immediately following the initial dementia diagnosis, average Medicare expenditures for Blacks were $26,337 and $20,429, compared with $21,399 and $23,176 for Hispanics and $17,182 and $18,244 for whites. The last year of life was responsible for $51,294 in costs for Blacks, $47,469 for Hispanics, and $39,499 for whites.
Greater use of high-cost care—such as emergency department, inpatient, and intensive care—drove these differences, especially during the last year of life.
“Higher expenditures do not necessarily result in higher quality care or better outcomes,” said corresponding author Natalia Olchanski, PhD, Assistant Research Professor at the Center for the Evaluation of Value and Risk in Health at Tufts Medical Center. “Some differences in care utilization may be due to the preferences of the people with dementia and their caregivers, but the trends we identified also raise the possibility of unequal access and disparities in quality of care. It’s clear from our study that improvements are needed in all phases of care to enhance care management for people with dementia and reduce disparities for disadvantaged populations.”
URL upon publication: https://onlinelibrary.wiley.com/doi/10.1111/jgs.18822
Additional Information
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About the Journal
Journal of the American Geriatrics Society is the go-to journal for clinical aging research. We provide a diverse, interprofessional community of healthcare professionals with the latest insights on geriatrics education, clinical practice, and public policy — all supporting the high-quality, person-centered care essential to our well-being as we age.
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JOURNAL
Journal of the American Geriatrics Society
ARTICLE TITLE
Racial and ethnic differences in disease-course Medicare expenditures for beneficiaries with dementia
ARTICLE PUBLICATION DATE
20-Mar-2024
Racial and ethnic differences in telemedicine use
JAMA Health Forum
About The Study: The results of this study of Medicare enrollees suggest that although nationally, Black and Hispanic individuals and individuals of other racial groups received more telemedicine visits during the pandemic and disproportionately lived in geographic regions with higher telemedicine use, after controlling for geographic region, Black and Hispanic individuals and individuals of other racial groups received fewer telemedicine visits than white individuals.
Authors: Felippe O. Marcondes, M.D., M.P.H., of Massachusetts General Hospital in Boston, is the corresponding author.
(doi:10.1001/jamahealthforum.2024.0131)
Editor’s Note: Please see the article for additional information, including other authors, author contributions and affiliations, conflict of interest and financial disclosures, and funding and support.
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About JAMA Health Forum: JAMA Health Forum is an international, peer-reviewed, online, open access journal that addresses health policy and strategies affecting medicine, health and health care. The journal publishes original research, evidence-based reports and opinion about national and global health policy; innovative approaches to health care delivery; and health care economics, access, quality, safety, equity and reform. Its distribution will be solely digital and all content will be freely available for anyone to read.
Patient characteristics and telemedicine use in the US, 2022
JAMA Network Open
About The Study: In this study of 5,437 U.S. adults with health care visits in 2022, many patients, including those with the greatest care needs, chose telemedicine even after in-person visits were available. These findings support continuing this care delivery approach as an option valued by patients. Differences were not observed by most common measures of socioeconomic status. Continued monitoring of telemedicine use is needed to ensure equitable access to health care innovations.
Authors: Eva Chang, Ph.D., M.P.H., of Advocate Health in Milwaukee, is the corresponding author.
To access the embargoed study: Visit our For The Media website at this link https://media.jamanetwork.com/
(doi:10.1001/jamanetworkopen.2024.3354)
Editor’s Note: Please see the article for additional information, including other authors, author contributions and affiliations, conflict of interest and financial disclosures, and funding and support.
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About JAMA Network Open: JAMA Network Open is an online-only open access general medical journal from the JAMA Network. On weekdays, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication.
JOURNAL
JAMA Network Open
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