Gaps In Quality Of Care Not Consistent Between Traditional Medicare, Medicare Advantage For Racial And Ethnic Groups

Area of Science:

• Health Services Research
• Health Equity Studies
• Racial and Ethnic Health Disparities

Background:

• Medicare Advantage is a growing source of coverage for racial and ethnic minority groups.
• Quality of care in Medicare Advantage is critical for achieving health equity.
• Understanding disparities in care quality is essential for vulnerable populations.

Purpose of the Study:

• To compare quality-of-care gaps between Medicare Advantage (MA) and traditional Medicare (TM).
• To examine differences in adverse health events for racial and ethnic minority groups versus non-Hispanic White populations.
• To assess how these gaps vary by specific quality measures and minority group.

Main Methods:

• Comparative analysis of quality-of-care outcomes between MA and TM.
• Focus on three key quality measures: avoidable emergency department use, preventable hospitalizations, and 30-day hospital readmissions.
• Stratification of analysis by racial and ethnic minority group (Hispanic, non-Hispanic Black, Asian) compared to non-Hispanic White individuals.

Main Results:

• Hispanic vs. non-Hispanic White gaps were smaller in MA than TM for all outcomes.
• Non-Hispanic Black vs. non-Hispanic White gaps were larger in MA for avoidable ED use but smaller for preventable hospitalizations.
• Asian vs. non-Hispanic White gaps showed mixed results, with larger gaps in MA for hospital readmissions.

Conclusions:

• Quality-of-care gaps for racial and ethnic minority groups differ between MA and TM.
• The relative performance of MA and TM varies significantly by minority group and quality measure.
• Continued monitoring of MA quality for minority enrollees is crucial as enrollment increases.