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Healthcare Utilization Among Hispanic Medicare Enrollees with Complex Chronic Conditions: Puerto Rico and Florida
Matthew Campos, Maricruz Rivera‐Hernandez. Innovation in Aging, 2025-12-01
Topic: Risk, prevention and care in population studies
Abstract Despite higher rates of chronic conditions such as dementia and diabetes, Medicare spending per beneficiary in Puerto Rico (PR) remains significantly lower than on the U.S. mainland (Campos & Rivera-Hernandez, 2024). This study compares the prevalence and demographic profile of Medicare fee-for-service (FFS) beneficiaries (65+) with multiple complex chronic conditions (MCCs) in PR to Hispanic FFS beneficiaries in Florida (FL) and examines whether differences in spending may be driven by variations in service use and access. We analyzed data from the 2022 Medicare Beneficiary Summary File (MBSF), including the Cost and Utilization and 30 CCW Chronic Conditions Segments. Eligible beneficiaries were ≥65, Hispanic, non-dual eligible, and continuously enrolled in Medicare Parts A and B. We stratified by MCCs (2+ complex conditions) and assessed service utilization (dichotomous outcomes (zero vs. any use)) across 17 Medicare spending categories. Demographics were compared using Chi-square and ANOVA tests, and logistic regression models estimated service use differences, adjusting for key covariates. Among FFS beneficiaries, 19.15% (n = 4965/25928) of PR beneficiaries had MCCs, compared to 18.26% (n = 12036/65923) in FL. PR beneficiaries were older and more likely to qualify for Medicare through disability insurance benefits (DIB). Chronic kidney disease was the most common complex condition. PR beneficiaries were significantly less likely than FL beneficiaries to have a claim in 16 of 17 spending categories for those with MCCs and in 14 of 17 categories for those without MCCs (both p < .0001). These findings highlight potential access and quality-of-care issues in PR, with implications for Medicare Advantage benchmarks.
Key findings
- Abstract Despite higher rates of chronic conditions such as dementia and diabetes, Medicare spending per beneficiary in Puerto Rico (PR) remains significantly lower than on the U.S. mainland (Campos & Rivera-Hernandez, 2024).
- Among FFS beneficiaries, 19.15% (n = 4965/25928) of PR beneficiaries had MCCs, compared to 18.26% (n = 12036/65923) in FL.
- PR beneficiaries were significantly less likely than FL beneficiaries to have a claim in 16 of 17 spending categories for those with MCCs and in 14 of 17 categories for those without MCCs (both p < .0001).
- These findings highlight potential access and quality-of-care issues in PR, with implications for Medicare Advantage benchmarks.
Why it matters
This study compared Hispanic Medicare beneficiaries with multiple complex chronic conditions, including dementia, in Puerto Rico and Florida, finding lower service use in Puerto Rico. It is about healthcare utilization and access, not about treating, curing, or preventing Alzheimer's disease.
Study details
- Participants4,965
- Effect size19.15%; 18.26%
- Evidence strengthLow
How this study scored 35/100
Published in a peer-reviewed journal. Scored zero for study design and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Innovation in Aging) |
| Journal's citation record | 0 / 4 | Innovation in Aging: journal h-index 48 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 4 / 5 | 2025 — within 3 year(s) of the newest study here |
| Sample size | 3 / 4 | 4,965 participants |
| Effect reported | 2 / 3 | Effect reported as a number, without an interval or test |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 0 / 7 | Cited 0 times (OpenAlex, 2026-10-10) |
| Citations per year | 0 / 5 | 0.0 citations a year over 3 year(s) since 2025 |
| Impact for its field and year | 0 / 6 | Cited 0.0× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 0 / 4 | Cited 0 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 1 / 4 | Last-listed author Maricruz Rivera‐Hernandez: h-index 18 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | Brown University: institution h-index 1,120 (OpenAlex) |
| Multi-centre collaboration | 0 / 3 | OpenAlex lists 1 institution(s) in 1 country — scores zero (affiliation lists can be incomplete) |
| Indexed in PubMed | 1 / 2 | Not in PubMed, but has a DOI |
| Free to read | 2 / 2 | Free to read |
| Total | 35 / 100 | — |
What each of these 20 components measures, and what this score is not →
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Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
APA 7th
Campos, M., & Rivera‐Hernandez, M. (2025). Healthcare Utilization Among Hispanic Medicare Enrollees with Complex Chronic Conditions: Puerto Rico and Florida. Innovation in Aging. https://doi.org/10.1093/geroni/igaf122.3341
Vancouver
Campos M, Rivera‐Hernandez M. Healthcare Utilization Among Hispanic Medicare Enrollees with Complex Chronic Conditions: Puerto Rico and Florida. Innovation in Aging. 2025. doi:10.1093/geroni/igaf122.3341.
BibTeX
@article{campos2025-58191ec1,
author = {Campos, Matthew and Rivera‐Hernandez, Maricruz},
title = {{Healthcare Utilization Among Hispanic Medicare Enrollees with Complex Chronic Conditions: Puerto Rico and Florida}},
journal = {Innovation in Aging},
year = {2025},
doi = {10.1093/geroni/igaf122.3341},
url = {https://doi.org/10.1093/geroni/igaf122.3341}
}