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. 2014 Apr;49(2):526-45.
doi: 10.1111/1475-6773.12100. Epub 2013 Aug 28.

Does the racial/ethnic composition of Medicare Advantage plans reflect their areas of operation?

Robin Weinick  1 , Amelia Haviland, Katrin Hambarsoomian, Marc N Elliott
Affiliations

Does the racial/ethnic composition of Medicare Advantage plans reflect their areas of operation?

Robin Weinick et al. Health Serv Res. 2014 Apr.

Abstract

Objective: To assess the extent to which the racial/ethnic composition of Medicare Advantage (MA) plans reflects the composition of their areas of operation, given the potential incentives created by the Centers for Medicare & Medicaid Services' Quality Bonus Payments for such plans to avoid enrolling racial/ethnic minority beneficiaries.

Data sources/study setting: 2009 Medicare Consumer Assessment of Healthcare Providers and Systems (MCAHPS) survey and administrative data from the Medicare Enrollment Database.

Data collection/extraction methods: We defined each plan's area of operation as all counties in which it had MA enrollees, and we created a matrix of race/ethnicity by plan by county of residence to assess the racial/ethnic distribution of each plan's enrollees in comparison with the racial/ethnic composition of MA beneficiaries in its operational area.

Principal findings: There is little evidence that health plans are selectively underenrolling blacks, Latinos, or Asians to a substantial degree. A small but potentially important subset of plans disproportionately serves minority beneficiaries.

Conclusions: These findings provide a baseline profile that will enable crucial ongoing monitoring to assess how the implementation of Quality Bonus Payments may affect MA plan coverage of minority populations.

Keywords: Medicare Advantage; Race/ethnicity; public quality reporting.

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Figures

Figure 1
Figure 1
Proportion of Plan Enrollees from Given Racial/Ethnic Group Compared with Group Representation in Plan Operational Area
Figure 2
Figure 2
Proportion of Plan Enrollees in Fair/Poor Health or with Less Than a High School Education Compared with Group Representation in Plan Operational Area Note. Size of circles is proportionate to size of plan enrollment. The symbol X is used to mark those SNP or non-SNP plans with fewer than 100 survey responses. Plans in shaded area have enrollment from given racial/ethnic group within 10 percentage points (dark shade) and 25 percentage points (light shade) of the overall average for their operational areas.
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