Racial differences in access to Medicare plans have health consequences

A study by Penn LDI finds that low access to five-star plans is linked to a high rate of preventable hospitalizations.

Access to high-quality health care differs for Black versus white Medicare Advantage enrollees, a reality that has been well documented. A 2022 study by LDI senior fellow Norma Coe, LDI executive director Rachel M. Werner, and Sungchul Park, now at Korea University, shows inequities in access to five-star Medicare Advantage plans: Black enrollees were offered fewer options for the higher-quality plans than white enrollees.

A home health aid holds the hand of a senior citizen.

The research team investigated how this inequitable access to high-quality Medicare plans might affect health outcomes and published their findings in the December 2022 issue of Medical Care.

Using data on Medicare Advantage beneficiaries, the researchers identified hospitalizations for ambulatory care-sensitive conditions, such as asthma, high blood pressure, and diabetes. Hospitalization for these diseases can often be avoided with better outpatient care and disease management. The researchers then analyzed associations among avoidable hospitalizations and beneficiaries’ race, ethnicity, and Medicare Advantage plan characteristics. Plan characteristics included star ratings, which are assigned based on quality measures that include preventive care.

They found that Black Medicare Advantage enrollees had significantly higher rates of avoidable hospitalizations compared to white enrollees. Per every 10,000 enrollees, Black beneficiaries had 39.4 more hospitalizations for ambulatory care-sensitive conditions than white beneficiaries.

Together with the earlier findings from the same dataset that showed racial and ethnic minority groups had lower access to higher-quality Medicare Advantage coverage, the results suggest that the disparities in avoidable hospitalizations trace back to inequitable access to care, at least in part.

This story is by Chris Tachibana. Read more at Penn LDI.