Socioeconomic Status and Medical Care Expenditures in Medicare Managed Care

35 Pages Posted: 27 Sep 2004 Last revised: 25 May 2018

See all articles by Kanika Kapur

Kanika Kapur

University College Dublin (UCD) - Department of Economics

Jeannette A. Rogowski

University of Medicine & Dentistry of New Jersey (UMDNJ) - School of Public Health; National Bureau of Economic Research (NBER)

Vicki A. Freedman

Policher Research Institute

Steven L. Wickstrom

Center for Health Care Policy and Evaluation - United Health Care

John L. Adams

RAND Corporation

Jose Escarce

University of California, Los Angeles (UCLA) - RAND Health Sciences Program; National Bureau of Economic Research (NBER)

Date Written: September 2004

Abstract

This study examined the effects of education, income, and wealth on medical care expenditures in two Medicare managed care plans. The study also sought to elucidate the pathways through which socioeconomic status (SES) affects expenditures, including preferences for health and medical care and ability to navigate the managed care system. We modeled the effect of SES on medical care expenditures using Generalized Linear Models, estimating separate models for each component of medical expenditures: inpatient, outpatient, physician, and other expenditures. We found that education, income, and wealth all affected medical care expenditures, although the effects of these variables differed across expenditure categories. Moreover, the effects of these SES variables were much smaller than the effects found in earlier studies of fee-for-service Medicare. The pathway variables also were associated with expenditures. Accounting for the pathways through which SES affects expenditures narrowed the effect of SES on expenditures; however, the change in the estimates was very small. Thus, although our measures of preferences and ability to navigate the system were associated with expenditures, they did not account for an appreciable share of the impact of SES on expenditures.

Suggested Citation

Kapur, Kanika and Rogowski, Jeannette A. and Freedman, Vicki A. and Wickstrom, Steven L. and Adams, John L. and Escarce, José, Socioeconomic Status and Medical Care Expenditures in Medicare Managed Care (September 2004). NBER Working Paper No. w10757. Available at SSRN: https://ssrn.com/abstract=590772

Kanika Kapur

University College Dublin (UCD) - Department of Economics ( email )

Newman Building (Room G215)
Belfield, Dublin 4
Ireland

Jeannette A. Rogowski

University of Medicine & Dentistry of New Jersey (UMDNJ) - School of Public Health ( email )

Department of Health Systems and Policy
335 George Street, Suite 2200
New Brunswick, NJ 08903
United States
732-235-9759 (Phone)
732-235-9780 (Fax)

National Bureau of Economic Research (NBER)

1050 Massachusetts Avenue
Cambridge, MA 02138
United States

Vicki A. Freedman

Policher Research Institute

No Address Available

Steven L. Wickstrom

Center for Health Care Policy and Evaluation - United Health Care

No Address Available

John L. Adams

RAND Corporation ( email )

P.O. Box 2138
1776 Main Street
Santa Monica, CA 90407-2138
United States

José Escarce (Contact Author)

University of California, Los Angeles (UCLA) - RAND Health Sciences Program ( email )

Los Angeles, CA 90095
United States
310-794-3842 (Phone)
310-794-0726 (Fax)

National Bureau of Economic Research (NBER)

1050 Massachusetts Avenue
Cambridge, MA 02138
United States

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