African Americans in commercial HMOs more likely to delay prescription drugs and use the emergency room.

Abstract

Health Maintenance Organizations (HMOs) are designed to provide comprehensive health care, including primary care to their enrollees. However, HMOs deliver care through a wide variety of physician networks, settings and methods throughout the nation and in California. Minorities and individuals of lower socioeconomic status continue to disproportionately rely on the health care safety net, even when insured. Individuals enrolled in HMOs should be less likely to rely on emergency rooms and experience ambulatory care sensitive hospitalizations given the focus of HMOs on centralized care through the use of a primary care provider. This policy brief uses data from the 2007 California Health Interview Survey (CHIS 2007) to examine delays in fulfilling prescribed medications, delays in obtaining needed medical care, visits to emergency rooms, and the presence of a usual source of care among insured African Americans in public and commercial HMOs. We find that African-American HMO enrollees in California are more likely to delay obtaining needed medications and use the emergency room than other racial/ethnic groups in comparable HMO plans.