Making Medicare color-blind: How groups are striving for equality in care

Racial health inequities are well-documented in Medicare, but peer review organizations are working to even the score.

By Geri Aston, AMNews staff. Dec. 3, 2001.

Every year researchers uncover more bad news to add to the growing body of evidence that racial disparities in health care continue to plague Medicare.

Most recently, it was that influenza vaccination rates are 21.6% lower among black beneficiaries compared with white ones. In years past, it was that black heart attack patients were less likely than white ones to undergo potentially life-saving cardiac catheterization, or that black Medicare beneficiaries with pneumonia were much less likely than white counterparts to get antibiotics in an appropriate time frame.

But a group of Medicare contractors has taken that bad news to heart and is working at the community level to reverse the trend.

The effort started in 1999 when the Centers for Medicare & Medicaid Services began requiring the peer review organizations it contracts with to launch quality initiatives designed to lessen the inequities in their states. CMS' action was inspired by the Healthy People 2010 goal to eliminate racial or ethnic health disparities.

"As a country, we should be appalled that there are these health care disparities," said Dawn Fitzgerald, vice president and director of the Disadvantaged Area Support Peer Review Organization, which provides all the other PROs with help on their disparity projects.

The reasons given for the differences in treatment are many. They include distrust among some minorities of the health care system, cultural barriers to care, low education levels, financial obstacles, language barriers between doctors and patients, and subconscious stereotypes among physicians about patients of certain races that find their way into treatment recommendations. [...]