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Inside this issue:

      A growing body of evidence shows disparities in quality of care among Medicare beneficiaries of different racial and ethnic backgrounds. These disparities are particularly noteworthy in Medicare, which provides nearly universal access to care to the elderly without regard to race or ethnicity.

 

     Studies have found that racial and ethnic minorities receive less access to care and poorer quality treatment and experience worse health outcomes than whites, according to United Press International  (UPI).

 

      Renee Landers, a health law professor at Suffolk University Law School, said Medicare could immediately begin to address the issue by providing beneficiaries with information on how to navigate the health system and requiring hospitals to collect and maintain data on the relationship between treatment and race. She said, "Medicare is the largest purchaser of health care and has a tremendous influence on all aspects of health care in this country," adding, "It has the obligation to ensure that all beneficiaries receive appropriate care on a fair and nondiscriminatory basis."

 

     Bob Griss, executive director of the Institute of social Medicine and Community Health, said HHs should ensure providers are giving equal treatment and then impose penalties if there is unequal treatment. Griss said that Medicare officials are "not fulfilling [their] responsibility to address this form of discrimination," adding, "They have so much clout, but they're not using it." Carolyn Clancy, director of the Agency for Healthcare and Quality , said the outreach program used to promote the Medicare drug benefit could serve as a model to help reduce disparities. She added, "Outreach for Part D built really useful infrastructure. People across the country sat down at churches and community centers to explain the program. More engaged patients get better health care." Peter Bach, a health researcher and physician at Memorial Sloan-Kettering Cancer Center, said that resources should be focused on persuading physicians to adhere to clinical guidelines, noting that if doctors do so, care should eventually become equal for all patients. He said, "The stubborn challenges that poverty poses extend far beyond the brick walls of health care institutions. There must be reasonable expectations for what Medicare can do" (Pierce, UPI)

       This suggests that quality of care, and not just access problems, underlie different treatment patterns among ethnic groups. Medicare can influence quality of care through its payment policy and conditions for participation, but what, if any, are the appropriate mechanisms to do so?

February 2007   Issue #8