Analysis of Medicare Data Finds Significant Disparities in Health Care Access and Utilization for People with Parkinson Disease
Results from a Medicare analysis study published in the journal npj Parkinson’s Disease revealed disparities in health care access and utilization for women, people of color, and rural residents with Parkinson disease (PD). According to the analysis, an estimated 250,000 people with PD did not access specialist care for their PD in 2019.
The retrospective observational study included 685,116 Medicare beneficiaries from the 2019 calendar year with at least 1 claim with an ICD-10 diagnostic code of G20 indicating Parkinson disease, and who were continuously enrolled in full coverage Medicare Fee-for-Service (FFS) (Parts A and B) or a Medicare Advantage (Part C). Among PD Medicare beneficiaries from this study, 40% did not see a neurologist in 2019 and only 9.1% visited a movement disorder specialist (MDS). Male beneficiaries living with PD were more likely to have at least 1 visit with a general neurologist (52.4%) or a MDS (9.8%) than women (48.9% and 8.4% respectively). White beneficiaries were more likely to have at least one general neurology visit or MDS visit (51.3% and 9.4% respectively) than Asian beneficiaries (49.1% and 7.8%), Hispanic beneficiaries (48.6% and 4.6%), North American Native beneficiaries (44.5% and 5.0%), and Black beneficiaries (43.9% and 5.4%). Beneficiaries residing in non-rural areas were more likely to have at least 1 visit with a general neurologist or MDS (51.5% and 9.5% respectively) than beneficiaries residing in rural areas (47.7% and 7.2%). Furthermore, beneficiaries with at least 1 MDS visit were more likely to utilize mental health services and non-pharmacological therapies, including physical, occupational, and speech-language therapy providers.
The study has several limitations: the length of PD diagnoses was not measured; analysis was restricted to a single calendar year; analysis was subject to the accuracy of Medicare billing codes; and Medicare beneficiaries were only able to submit a single response for racial/ethnic categorization, limiting accurate categorization of the PD population. This study highlights various barriers to health care access and the need for additional research on population-specific barriers to health care services for people living with PD.