A recent report released by the Centers for Medicare & Medicaid Services (CMS) Office of Minority Health, Disparities in Health Care in Medicare Advantage Associated with Dual Eligibility or Eligibility for a Low-Income Subsidy and Disability, outlines disparities in care in Medicare Advantage. The report examined the performance of Medicare Advantage (MA) plans on specific measures of quality of health care reported in 2021. The report compared the quality of clinical care for four groups of MA enrollees that are defined based on the combination of two characteristics: (1) dual eligibility for Medicare and Medicaid or eligibility for a Part D Low-Income Subsidy (LIS) and (2) disability. The measures were for care received in 2020. For the purposes of the report, disability status was based on the individual’s original reason for Medicare entitlement.
The report found that dually eligible beneficiaries with disabilities fare worse on several quality measures, though inequities in quality exist among all dual eligible enrollees, when compared to non-dual eligible enrollees.
“Regardless of disability status, DE/LIS MA enrollees had below-average scores on more than one-third of measures examined and above-average scores for only one or two measures relative to all MA enrollees. Disparities for DE/LIS MA enrollees were most commonly observed in the areas of cancer screening, care for mental illness, care coordination, and overuse and appropriate use of medication.”
The report is based on an analysis of Healthcare Effectiveness Data and Information Set (HEDIS) data on the quality of care delivered to people with Medicare who are enrolled in MA plans. HEDIS is composed of information collected from medical records and administrative data on the clinical quality of care that MA enrollees receive for a variety of medical issues. The report was released by the CMS Office of Minority Health in collaboration with the RAND corporation.
The Center for Medicare Advocacy is committed to promoting health equity and eliminating disparities in care and health outcomes for beneficiaries. Though this study is helpful in highlighting inequities, additional research is needed to build from these results. The Center will continue to monitor and highlight inequities to achieve a robust understanding of areas of concern and to strive to develop and promote policy solutions to address these inequities to improve care and quality of life for all beneficiaries.
June 22, 2023 – K. Kertesz