Medicare Resource Use Differs by English Reading Proficiency

Area of Science:

• Health Services Research
• Health Communication
• Health Disparities

Background:

• Medicare coverage decisions are complex for beneficiaries.
• The Centers for Medicare & Medicaid Services (CMS) offers informational resources (hotline, handbook, website).
• Factors influencing the use of these CMS resources are not well understood.

Purpose of the Study:

• To examine limited English speaking and reading proficiency as predictors of CMS Medicare informational resource use.
• To assess differences in the likelihood of using CMS resources among Medicare beneficiaries with limited English proficiency.

Main Methods:

• Utilized 2016-2018 Medicare Current Beneficiary Survey data (n=20,715).
• Employed linear probability models, adjusting for demographic, socioeconomic, health, and local market factors.
• Primary outcome: indicator of using at least one of the three CMS resources.

Main Results:

• 4.8% had limited English speaking proficiency; 7.0% had limited English reading proficiency.
• Beneficiaries with limited English reading proficiency were 16.3 percentage points less likely to use a CMS resource (p < .001).
• Limited English speaking proficiency was not significantly associated with CMS resource use.

Conclusions:

• English reading proficiency is an underappreciated factor in Medicare beneficiaries' access to informational resources.
• Alternative strategies for providing and publicizing Medicare information may reduce barriers for beneficiaries with limited English reading skills.
• Addressing reading proficiency barriers can improve equitable access to Medicare benefits and coverage information.