A recent Health Affairs study, Gaps In Quality Of Care Not Consistent Between Traditional Medicare, Medicare Advantage For Racial And Ethnic Groups, examined gaps in quality of care when comparing traditional Medicare and Medicare Advantage for different racial and ethnic minority group for three quality-of-care outcomes. The study “found that the relative magnitude of the gaps varied both by racial and ethnic minority group and by quality measure . . . suggest[ing] that MA does not equally [affect] the quality of care across all racial and ethnic groups…” The study looked at avoidable Emergency Department use, preventable hospitalizations, and thirty-day hospital readmissions.
Some findings, cited directly form the study:
- Hispanic versus non-Hispanic White gaps were smaller in Medicare Advantage than in traditional Medicare for all outcomes: avoidable emergency department use, preventable hospitalizations, and thirty-day hospital readmissions.
- The gap between non-Hispanic Black and non-Hispanic White populations was larger in Medicare Advantage than in traditional Medicare for avoidable emergency department use but was no different for hospital readmissions and was smaller for preventable hospitalizations.
- The Asian versus non-Hispanic White gap was similar in Medicare Advantage and traditional Medicare for avoidable emergency department use and preventable hospitalizations but was larger in Medicare Advantage for hospital readmissions.
- In summary, the differences in racial and ethnic gaps between MA and traditional Medicare were specific to racial and ethnic minority groups, and they varied across quality measures. This suggests that MA plans’ care management strategies do not provide appropriate care to all patients, and they might not be effective in reducing all potentially avoidable adverse health events.
- MA plans need to identify particular situations in which a certain racial or ethnic group does not do as well as other groups and to develop strategies that effectively address those situations. Such targeted approaches could help MA plans contribute to narrowing racial and ethnic gaps in the quality of care.
April 4, 2024 – K. Kertesz