Does the Racial/Ethnic Composition of Medicare Advantage Plans Reflect Their Areas of Operation?
Article first published online: 28 AUG 2013
© Health Research and Educational Trust
Health Services Research
Volume 49, Issue 2, pages 526–545, April 2014
How to Cite
Weinick, R., Haviland, A., Hambarsoomian, K. and Elliott, M. N. (2014), Does the Racial/Ethnic Composition of Medicare Advantage Plans Reflect Their Areas of Operation?. Health Services Research, 49: 526–545. doi: 10.1111/1475-6773.12100
- Issue published online: 27 MAR 2014
- Article first published online: 28 AUG 2013
- Manuscript Accepted: 2 JUN 2013
- CMS. Grant Number: HHSM-500-2005-00028I
- Medicare Advantage;
- public quality reporting
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.
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.
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.