Racial and income differences in use of the hospice benefit between the medicare managed care and medicare fee-for-service.
OBJECTIVE
To examine whether use of the Medicare Hospice Benefit between health maintenance organization (HMO) and Fee-For-Service (FFS)-enrolled beneficiaries varies by income or race.


METHODS
Medicare enrollment and claims data for South Florida.


RESULTS
In the FFS system, rate of death in hospice varied by income. In the HMO system, it did not. Time spent in hospice varied by income in the HMO system and not in the FFS system. There was little evidence that racial differences in hospice use differed between FFS and HMO options.


CONCLUSIONS
These differences raise questions about whether some hospice use may be in response to system-level incentives.
Virnig
B A
BA
University of Minnesota, School of Public Health, Division of Health Management and Policy, Minneapolis, Minnesota 55455, USA. virni001@tc.umn.edu
Morgan
R O
RO
Persily
N A
NA
DeVito
C A
CA