Racial disparities in avoidable hospitalizations for Medicare beneficiaries

More than 40% of Medicare beneficiaries now choose Medicare Advantage (MA) private plans. As the number of MA beneficiaries grows—particularly among Black and Latinx communities—it is important to understand how enrollment in MA affects racial disparities in quality of care. A new Medical Care study by LDI Fellow Norma Coe and colleagues finds cause for concern, revealing racial disparities in avoidable hospitalizations that are even greater than in traditional Medicare.

Hand of an African American person on a hospital bed with a hospital bracelet and an IV drip.

For “ambulatory-care sensitive conditions” (ACSCs) such as diabetes, asthma, urinary tract infections, and heart failure, early interventions and good primary care can prevent the need for hospitalization. In traditional Medicare, disparities in ACSC hospitalization among Black and white beneficiaries has been well-documented. Despite the hope that MA plans could close this gap, Coe and colleagues find even greater disparities between Black and white MA beneficiaries.

Using 2015-2016 national inpatient Medicare data, the authors found that Black beneficiaries had higher adjusted rates of avoidable hospitalization than white beneficiaries in both traditional Medicare and MA, with greater disparities in MA. White beneficiaries had similar rates of avoidable hospitalizations in traditional Medicare and MA; however, Black beneficiaries had higher rates of avoidable hospitalizations in MA than traditional Medicare. As a result, the racial difference was wider in MA than in traditional Medicare.

This story is by Elizabeth Donhauser and Janet Weiner. Read more at Penn LDI.