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Journal article
Racial and ethnic disparities in access to and enrollment in high-quality Medicare Advantage plans
Health services research
09 Apr 2022
PMID: 35342936
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Objective Racial and ethnic minority enrollees in Medicare Advantage (MA) plans tend to be in lower-quality plans, measured by a 5-star quality rating system. We examine whether differential access to high-rated plans was associated with this differential enrollment in high-rated plans by race and ethnicity among MA enrollees. Data Sources The Medicare Master Beneficiary Summary File and MA Landscape File for 2016. Study Design We first examined county-level MA plan offerings by race and ethnicity. We then examined the association of racial and ethnic differences in enrollment by star rating by controlling for the following different sets of covariates: (1) individual-level characteristics only, and (2) individual-level characteristics and county-level MA plan offerings. Data Collection/Extraction Methods Not applicable Principal Findings Racial and ethnic minority enrollees had, on average, more MA plans available in their counties of residence compared to White enrollees (16.1, 20.8, 20.2, vs. 15.1 for Black, Asian/Pacific Islander, Hispanic, and White enrollees), but had fewer number of high-rated plans (4-star plans or higher) and/or more number of low-rated plans (3.5-star plans or lower). While racial and ethnic minority enrollees had lower enrollment in 4-4.5 star plans than White enrollees, this difference substantially decreased after accounting for county-level MA plan offerings (-9.1 to -0.5 percentage points for Black enrollees, -15.9 to -5.0 percentage points for Asian/Pacific Islander enrollees, and -12.7 to 0.6 percentage points for Hispanic enrollees). Results for Black enrollees were notable as the racial difference reversed when we limited the analysis to those who live in counties that offer a 5-star plan. After accounting for county-level MA plan offerings, Black enrollees had 3.2 percentage points higher enrollment in 5-star plans than White enrollees. Conclusions Differences in enrollment in high-rated MA plans by race and ethnicity may be explained by limited access and not by individual characteristics or enrollment decisions.
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Details
- Title
- Racial and ethnic disparities in access to and enrollment in high-quality Medicare Advantage plans
- Creators
- Sungchul Park - Ewha Womans UniversityRachel M. Werner - Philadelphia VA Medical CenterNorma B. Coe - University of Pennsylvania
- Publication Details
- Health services research
- Publisher
- Wiley
- Number of pages
- 11
- Grant note
- R01AG057501; P30AG012836 / National Institutes of Health; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA National Institute of Aging; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute on Aging (NIA)
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Health Management and Policy
- Web of Science ID
- WOS:000779577700001
- Scopus ID
- 2-s2.0-85127699560
- Other Identifier
- 991019167319704721
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Health Care Sciences & Services
- Health Policy & Services