Report: Trends in Racial, Ethnic, Sex, and Rural-Urban Inequities in Health Care in Medicare Advantage: 2009-2018

From the Centers for Medicare and Medicaid Services Office of Minority Health

The Centers for Medicare and Medicaid Services Office of Minority Health has published a new report, Trends in Racial, Ethnic, Sex, and Rural-Urban Inequities in Health Care in Medicare Advantage: 2009-2018.

Since 2015, CMS OMH has published annual reports to highlight inequities in the quality of care delivered to Medicare beneficiaries nationwide based. Until now, these annual reports have focused on comparisons within a single year. An investigation of historical trends can provide important perspective on inequities. This report presents an analysis of historical trends in inequities by race, ethnicity, sex, and geography among Medicare beneficiaries enrolled in Medicare Advantage (MA) plans nationwide.

This report reveals the extent to which there has been progress in reducing or eliminating initial inequities in those areas. Focusing on a set of patient experience and clinical care measures that are comparable across a 10-year period, the report describes inequities that existed in 2009, how those inequities changed over the 10-year period, how scores for each beneficiary group changed over time, and what inequities remained in 2018.

In all, this report provides data regarding four patient experience measures and seven clinical care measures. Patient experience data were collected via an annual national survey of Medicare beneficiaries, known as the Medicare Consumer Assessment of Healthcare Providers and Systems (CAHPS®) survey from 2009 to 2018. Clinical care data were gathered through medical records and insurance claims or encounter data for hospitalizations, medical office visits, and procedures as part of the Healthcare Effectiveness Data and Information Set (HEDIS®).

The findings of the report detail reductions in inequities for specific populations across different measures, including several substantial reductions in inequities and improvements in care. While these results are encouraging, further investigation is needed to understand the reason for the large improvements in care that occurred for Black and Hispanic beneficiaries and for rural residents, since lessons learned from such an investigation could potentially be applied to ensure continued progress toward greater healthcare equity for all beneficiaries.

 

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