Principal Investigator
PI Home Department
Source of Support
Total Cost
Debora Paterniti, Ph.D.
General Internal Medicine
Nat'l Institute on Aging*
10/01/2003 - 9/30/2005

This study has two broad objectives. First, we will examine the availability of Medicare HMOs and benefit packages for beneficiaries of differing race/ethnic classifications, how HMO enrollment rates are related to race/ethnic classification and range of plan benefits, and how the availability of the HMOs and HMO enrollment by different race/ethnic groups changed subsequent to implementation of BBA provisions. Second, we will determine individual level characteristics related to HMO plan enrollment among elderly white, black and Hispanic Medicare beneficiaries, whether factors which elderly black and Hispanic beneficiaries report as influencing their enrollment in HMOs differ from those that influence white Medicare beneficiaries, and whether black and Hispanic beneficiaries enrolled in HMOs differ from HMO enrolled elderly white beneficiaries in terms of their self-reported health, use of health care, and perceived access to care. We will use both population-based (using Medicare administrative data) survey methodologies to examine the availability of plans and services, plan selection by enrollees, and individual level factors affecting access to and use of medical care.

The survey comparing Original Medicare and Medicare + Choice plans has been distributed to a random sample of plan enrollees nation-wide. Concomitantly, a qualitative study of participants’ perceptions of health plans and plan organization has been on-going. The pilot study has included four focus group interviews of ethnically diverse (African American, White, and Latino) men and women, ages 65 and over, conducted in English and Spanish. In addition, we are currently completing cognitive interviews, whose responses will be used to interpret survey responses as well as to assist in future design of consumer surveys related to plan interpretation and selection. Preliminary results of qualitative interviews will be presented at the 2004 American Public Health Association Meetings.

* Subcontract with Baylor College of Medicine (Robert O. Morgan Ph.D.)
** ($1,400,000)