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Profile of Medicare Beneficiaries by Race and Ethnicity: A Chartpack

Introduction
  1. P. Reynolds, "The Federal Government's Use of Title VI and Medicare to Racially Integrate Hospitals in the United States, 1963 through 1967," American Journal of Public Health, 87(11):1850-1858, November 1997.

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  2. P. Lee, "Battling for the Right Health Policy, Then and Now," Generations, 39(2):15-20, Summer 2015.

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  3. Kaiser Family Foundation, "The Story of Medicare: A Timeline," May 2015, available at: http://kff.org/medicare/video/the-story-of-medicare-a-timeline/.

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  4. C. James, “Medicare and Minority Communities: Reflections on 50 Years of Progress and a Vision for the Future,” Generations, 29(2): 58-66, Summer 2015.

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  5. U.S. Centers for Disease Control, National Center for Health Statistics, Health, United States, 2014, Table 16: “Life expectancy at birth, age 65, and at age 75, by sex, race, and Hispanic origin: United States, selected years 1900-2013, available at: http://www.cdc.gov/nchs/data/hus/hus14.pdf#016.

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  6. R. Williams, “Medicare and Communities of Color,” National Academy of Social Insurance, No.11: November 2004.

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  7. M. Gornick, “A Decade of Research on Disparities in Medicare Utilization: Lessons for the Health and Health Care of Vulnerable Men,” The American Journal of Public Health, 98 (Suppl 1): S162-S168, September 2008.

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  8. S. Joshi et al, “Disparities among Blacks, Hispanics, and Whites in Time from Starting Dialysis to Kidney Transplant Waitlisting,” Transplantation, 95(2):309-18, January 2013.

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  9. M. Halpern, “Disparities in Timeliness of Care for U.S. Medicare Patients Diagnosed with Cancer,” Curr Oncol, 19(6):e404-e413, December 2012.

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  10. Centers for Medicare & Medicaid Services (CMS), “Medicare Hospital Readmission Among Minority Populations: 2007-2013 Trends and Disparities,” Winter 2015, available at: https://www.cms.gov/About-CMS/Agency-Information/OMH/Downloads/OMH_Dwnld-MedicareHospitalReadmissionsAmongMinorityPopulations.pdf.

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  11. K. Joynt et al, “Thirty-day Readmission Rates for Medicare Beneficiaries by Race and Site of Care,” JAMA, 305(7): 675-681, February 2011.

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  12. J. Ayanian, B. Landon, J. Newhouse, and A. Zaslavsky, “Racial and Ethnic Disparities among Enrollees in Medicare Advantage Plans,” The New England Journal of Medicine, 371(24): 2288-2297, December 2014.

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  13. A. Trivedi, A. Zaslavsky, E. Schneider, and J. Ayanian, “Trends in Quality of Care and Racial Disparities in Medicare Managed Care,” The New England Journal of Medicine, 353(7):692-700, August 2005.

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  14. E. Schneider, A. Zaslavsky, and A. Epstein, “Racial Disparities in the Quality of Care for Enrollees in Medicare Managed Care,” JAMA, 287(10):1228-1294, March 2002.

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  15. S. Wallace, “Equity and Social Determinants of Health Among Older Adults,” Generations, 38(4): 6-11, Winter 2014-2015.

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  16. G. Jacobson, J. Huang, T. Neuman, and K. Smith, “Wide Disparities in Income and Assets of People on Medicare by Race and Ethnicity,” Kaiser Family Foundation, September 2013, available at: http://kff.org/medicare/report/wide-disparities-in-the-income-and-assets-of-people-on-medicare-by-race-and-ethnicity-now-and-in-the-future/.

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  17. K. Schulman et al, “The Effect of Race and Sex on Physicians’ Recommendations for Cardiac Catheterization,” N Engl J Med, 340(8):618-626, February 1999.

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  18. P. Bach et al, “Primary Care Physicians Who Treat Blacks and Whites,” JAMA, 351(6):575-584, August 2004.

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  19. Y. Li et al, “Nursing Staffing Hours at Nursing Homes with High Concentrations of Minority Residents, 2001-2011,” Health Affairs, 34(12):2132-2134, December 2015.

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  20. A. Barnato et al, “Hospital-level Racial Disparities in Acute Myocardial Infarction Treatment and Outcomes,” Med Care: 43(4): 308–319, April 2005.

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  21. J. Skinner, “Racial, Ethnic, and Geographic Disparities in Rates of Knee Arthroplasty among Medicare Patients,” N Engl J Med, 349(14):1350-9, October 2003.

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  22. R. Weech-Maldonado et al, “Language and Regional Differences in Evaluations of Medicare Managed Care by Hispanics,” Health Services Research, 43(2):552-568, April 2008.

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  23. N. Ponce et al, “Language Barriers to Health Care Access among Medicare Beneficiaries,” Inquiry, 43(1):66-76, Spring 2006.

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  24. R. Valdez et al, A Profile of Hispanic Elders, Horizons Project: Nationwide Demographic Report, Health Care Financing Administration, May 2000, available at: http://latino.si.edu/virtualgallery/growingold/Nationwide%20Demographic.pdf.

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  25. M. Heckler, The Heckler Report: Report of the Secretary’s Task Force on Black and Minority Health, U.S. Department of Health and Human Services, Office of Minority Health, 1985, available at: https://archive.org/details/reportofsecretar00usde.

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  26. Institute of Medicine, Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care, National Academies Press, 2002.

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  27. National Academy of Social Insurance, “Strengthening Medicare’s Role in Reducing Racial and Ethnic Health Disparities,” Medicare Brief No. 16, October 2006, available at: https://www.nasi.org/usr_doc/Medicare_Brief_No_016.pdf.

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  28. CMS, The CMS Equity Plan for Improving Quality in Medicare, September 2015, available at: https://www.cms.gov/About-CMS/Agency-Information/OMH/OMH_Dwnld-CMS_EquityPlanforMedicare_090615.pdf.

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  29. CMS, Guide to Preventing Readmissions among Racially and Ethnically Diverse Medicare Beneficiaries, January 2016, available at: https://www.cms.gov/About-CMS/Agency-Information/OMH/Downloads/OMH_Readmissions_Guide.pdf.

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  30. M. Boutaugh et al, “Closing the Disparity Gap: The Work of the Administration on Aging,” Generations, 38(4):107-118, Winter 2014-2015.

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  31. C. James, “Medicare and Minority Communities: Reflections on 50 Years of Progress and a Vision for the Future.”

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Chartpack
  1. Categories sum to more than 100% because Hispanics may be of any race.

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  2. R. Hummer and M. Hayward, "Hispanic Older Adult Health and Longevity in the United States: Current Patterns and Concerns for the Future.” Daedalus, 144(2):20-30, Spring 2015.

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  3. J. Lariscy et al, “Hispanic Older Adult Mortality in the United States: New Estimates and an Assessment of Factors Shaping the Hispanic Paradox,” Demography, 52(1):1-14, February 2015.

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  4. M. Hayward et al, “Does the Hispanic Paradox in U.S. Adult Mortality Extend to Disability?” Population Research and Policy, 33(1):81-96, February 2014.

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  5. For additional information about the official poverty measure and the SPM, both developed by the U.S. Census Bureau, and poverty rates among seniors, see J. Cubanski, G. Casillas, and A. Damico, "Poverty Among Seniors: An Updated Analysis of National and State Level Poverty Rates Under the Official and Supplemental Poverty Measures," Kaiser Family Foundation, June 2015, available at: http://kff.org/medicare/issue-brief/poverty-among-seniors-an-updated-analysis-of-national-and-state-level-poverty-rates-under-the-official-and-supplemental-poverty-measures/.

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  6. Income takes into account Social Security, pensions, earnings, and other income sources; including income from assets, rental income, and retirement account (IRA) withdrawals. Income is presented on a per person basis; for married people income is divided equally between spouses to calculate per capita income. For additional information, see G. Jacobson, C. Swoope, T. Neuman, and K. Smith, "Income and Assets of Medicare Beneficiaries, 2014–2030," Kaiser Family Foundation, September 2015, available at: http://kff.org/medicare/issue-brief/income-and-assets-of-medicare-beneficiaries-2014-2030/.

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  7. Total savings includes retirement account holdings (such as IRAs or 401Ks) and other financial assets, including savings accounts, bonds and stocks. Savings are presented on a per person basis; for married people, savings are divided equally between spouses to calculate per capita savings. For additional information, see G. Jacobson et al, "Income and Assets of Medicare Beneficiaries, 2014–2030."

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  8. CMS, 2011 Health and Health Care of the Medicare Population, Table 2.4: "Self-Reported Health Conditions and Risk Factors of Medicare Beneficiaries, by Race/Ethnicity and Age, 2011."

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  9. T. Neuman, G. Casillas, and G. Jacobson, “Medicare Advantage and Traditional Medicare: Is the Balance Tipping?” Kaiser Family Foundation, October 2015, available at: http://kff.org/medicare/issue-brief/medicare-advantage-and-traditional-medicare-is-the-balance-tipping/

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  10. Similarly, the National Health Interview Survey (NHIS) also finds lower shares of black and Hispanic beneficiaries reporting that they had seen or talked to a dentist in the past year compared with whites; see Centers for Disease Control and Prevention, National Center for Health Statistics, Health, United States, 2014, Table 84: “Dental visits in the past year, by selected characteristics: United States, selected years 1997-2013,” available at: http://www.cdc.gov/nchs/data/hus/hus14.pdf.

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  11. Kaiser Family Foundation, “Oral Health and Medicare Beneficiaries: Coverage, Out-of-Pocket Spending, and Unmet Need," June 2012, available at: http://kff.org/medicare/issue-brief/oral-health-and-medicare-beneficiaries-coverage-out/.

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  12. CMS, “Medicare Hospital Readmission Among Minority Populations: 2007-2013 Trends and Disparities."

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  13. K. Joynt et al, “Thirty-day Readmission Rates for Medicare Beneficiaries by Race and Site of Care.”

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  14. Centers for Disease Control and Prevention, National Center for Health Statistics, Health, United States, 2014, Table 76: "Use of mammography among women aged 40 and over, by selected characteristics: United States, selected years 1987–2013," available at: http://www.cdc.gov/nchs/data/hus/hus14.pdf.

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