Medicare Advantage data shows quality differences for ethnic minorities

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The Centers for Medicare and Medicaid Services for the first time has released data highlighting the racial and ethnic disparities in patient experience and in clinical care measures for Medicare Advantage beneficiaries.

The CMS report shows ratings of Asians/Pacific Islanders, blacks, Hispanics, American Indian/Alaska native, in comparison to white scores.

The new data is not being used to evaluate care through the Medicare Advantage and Part D Star Ratings program, nor is not it used for payment purposes, CMS said.

Despite advances in healthcare access, increases in spending, and improvements in quality over the last decade, there is well-documented evidence that members of racial and ethnic minority groups continue to experience worse health outcomes, CMS said.

The data in disparity of care for eight patient experience measures shows that in seven areas, Asians and Pacific Islanders rated their experience in scores worse than that of whites, compared to five areas for Hispanics, three areas for blacks and only two areas for American Indians and Alaska natives.

In only 1 area did American Indians/Alaska natives, and  Asians/Pacific Islanders give ratings that showed their care was better than that of whites.

[Also: CMS releases guide to preventing readmissions among racially and ethnically diverse beneficiaries]

In five areas, American Indians/Alaska natives, and blacks gave ratings that compared similarly to that of whites; in three areas, Hispanics gave ratings that compared to scores of whites. Asians and Pacific Islanders had no score in this category, rating their care in scores that were either better or worse than those of whites.

In rating 27 measures for clinical care, Asians and Pacific Islanders ratings were the highest in comparison to scores given by whites.

Asians/Pacific Islanders gave ratings that showed in 14 of the 27 measures they scored their clinical care higher than that of whites; in three of the measures, the ratings were worse; and in 10 they issued similar ratings.

Blacks and Hispanics gave ratings higher than whites in only three out of the 27 measures.

In 10 of the measures, blacks gave scores that were worse than those given by whites; and on 14 measures, they showed similar ratings.

Hispanics said in nine measures their care was worse than whites; in 15 similar; and in three, better.

CMS said what the data doesn't show is the reason for the disparities.

"Increasing understanding and awareness of disparities and their causes is the first step of our path to equity," said Dr. Cara James, director of the CMS Office of Minority Health. "While these data do not tell us why differences exist, they show where we have problems and can help spur efforts to understand what can be done to reduce or eliminate these differences."

[Also: HHS unveils plan to address racial, ethnic health disparities]

Beneficiaries were asked to give scores based on a 0 to 100 scale in eight categories of patient experience.

In categories of how easy it is to get needed care; getting needed prescription drugs; and getting information from their health plan about prescription drugs, whites gave the highest ratings, according to the survey.

In a question of getting appointments and care quickly; getting customer service from a health plan; and care coordination, American Indians/Alaska natives gave the highest scores.

Blacks gave the highest score when asked how well doctors communicate with them.

Asians and Pacific Islanders gave the highest score in a question of getting an annual flu vaccine.

The data was based on an analysis of two sources of information. One is the Healthcare Effectiveness Data and Information Set that collects information from medical records and also from administrative data on how well the needs of Medicare beneficiaries are met for a variety of medical issues, including diabetes, cardiovascular disease, and chronic lung disease.

The second is the Medicare Consumer Assessment of Healthcare Providers and Systems Survey, conducted annually by CMS, that focuses on the healthcare experiences of Medicare beneficiaries nationwide.  

"These data are a good first step in understanding disparities in Medicare Advantage," said Sean Cavanaugh, CMS deputy administrator and director of the Center for Medicare. "We look forward to working with plans in closing the differences in the quality of care that people with Medicare Advantage receive."  

Specific scores for patient experience are as follows:

In scores of how easy it is to get needed care, all groups surveyed gave an 80 percent or better favorable rating but whites scored the highest at 87 percent, a 7 percent difference from the lowest score of 80.6 given by Pacific Islanders. Native Americans/Alaska natives gave a score of 86.7 percent; blacks gave a score of 84.6 percent; Hispanics; 85.5 percent.

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In a question of getting appointments and care quickly, the highest score of 79.6 percent was given by American Indians and Alaska natives, followed by whites at 73.8 percent, blacks at 69.7 percent, Hispanics at 66.9 percent and Pacific Islanders at 62.4 percent.

In customer service from one's health plan when needed, American Indians and Alaska natives again gave the highest scores at 82.9 percent, followed by Hispanics at 82 percent; whites at 81.3 percent; and Pacific Islanders at 72.8 percent.

Survey results for how well doctors communicate with patients again showed Pacific Islanders feel left behind, compared to the other race and ethnic groups. They gave a rating of 86 percent; compared to the highest score given by blacks of 91.6 percent; American Indians and Alaska natives and also Hispanics at 91.2 percent, and in last place, whites at 90.6 percent.

The patient experience for care coordination showed that 87.4 percent of American Indians/Alaska natives rated the experience well; compared to 86.4 percent of whites; 86.3 percent of blacks; 82.5 percent of Hispanics; and 81 percent of Asians/Pacific Islanders.

In getting needed prescription drugs, whites gave the question the highest score at 91.1 percent, followed by blacks at 90 percent, Hispanics at 88 percent; American Indians/Alaska natives at 87.3 percent and Pacific Islanders at 85.1 percent.

Scores were lower when it came time to rate how easy it was to get information from their health plan about prescription drug coverage. Whites again gave the top rating of 82.2 percent, followed by American Indians/Alaska natives at 79.9 percent; blacks at 77.7 percent; Hispanics at 76.8 percent; and Pacific Islanders at 72.7 percent.

In getting a flu vaccine, Asians/Pacific Islanders gave a score of 82.4 percent; whites, 76.4 percent; Hispanics, 64.5 percent; American Indians/Alaska natives, 62.5 percent; and blacks 61.6 percent.

Twitter: @SusanJMorse