Medicare Advantage Care Differs by Race, Sex

Health care experiences and clinical care varies between women and men, as well for racial and ethnic groups according to new CMS report.

New data shows that there are differences and disparities in care based on both race and sex for beneficences enrolled in Medicare Advantage, according to a pair of reports released by the Centers for Medicare & Medicaid Services' Office of Minority Health (CMS OMH). One report compares quality of care between women and men, and the other report looks at racial and ethnic differences in healthcare experiences and clinical care, among women and men.

“This is the first time that CMS has released Medicare Advantage data on racial and ethnic disparities in care separately for women and men,” said Dr. Cara James, Director of the CMS Office of Minority Health. “Showing the data this way helps us to understand the intersection between a person’s race, ethnicity, and gender and their health care.”

Women received better treatment for chronic lung disease and rheumatoid arthritis and were more likely than men to receive proper follow-up care after being hospitalized for a mental health disorder, according to the first report focusing on gender. That said, women were less likely than men to receive timely treatment for alcohol or drug dependence, and they were more likely to be dispensed medications that are potentially harmful to people with certain medical conditions, such as dementia.

Disparities between Black and White MA beneficiaries in rates of colorectal cancer screening, treatment for chronic lung disease and acute myocardial infarction, and management of rheumatoid arthritis were larger for men than for women, according to the second report on racial and ethnic group comparisons. That report was a is a follow-up to a November 2016 report released by CMS Office of Minority Health which presented racial and ethnic group comparisons without stratifying by gender.

The reports were prepared in collaboration with the RAND Corporation, and are based on an analysis of two sources of information scores received in 2014-2015 and could be used by plans to improve healthcare quality and accountability for different racial and ethnic groups by gender at the national level. That said, CMS said the information in the reports shouldn’t be used to evaluate care through the Part C and D Star Ratings program, and are not used for payment purposes.

The reports used two key data sources: The first source is the Healthcare Effectiveness Data and Information Set (HEDIS). HEDIS collects information from medical records and administrative data on the technical quality of care that Medicare beneficiaries receive for a variety of medical issues, including diabetes, cardiovascular disease, and chronic lung disease. The second source of information is the Medicare Consumer Assessment of Healthcare Providers and Systems (CAHPS) Survey, which is conducted annually by CMS and focuses on the health care experiences of Medicare beneficiaries across the nation.

About the Author

David Kopf is the Editor of HME Business.


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