How Do the Experiences of Medicare Beneficiary Subgroups Differ between Managed Care and Original Medicare?

Abstract

Study Design. We defined seven subgroup characteristics: low-income subsidy eligible, no high school degree, poor or fair self-rated health, age 85 and older, female, Hispanic, and black. We estimated disparities in CAHPS experience of care scores between each of these groups and beneficiaries without those characteristics within MA and FFS for 11 CAHPS measures and assessed differences between MA and FFS disparities in linear models. Principal Findings. The seven subgroup characteristics had significant (po.05) negative interactions with MA (larger disparities in MA) in 27 of 77 instances, with only four significant positive interactions. Conclusion. Managed care may provide less uniform care than FFS for patients; specifically there may be larger disparities in MA than FFS between beneficiaries who have low incomes, are less healthy, older, female, and who did not complete high school, compared with their counterparts. There may be potential for MA quality improvement targeted at the care provided to particular subgroups.

Does the Racial/Ethnic Composition of Medicare Advantage Plans Reflect Their Areas of Operation?

“…, ; Elliott et al. ; Haviland et al. ), such programs could potentially incentivize MA plans to avoid enrolling beneficiaries from minority racial/ethnic groups.…”

Medicare Advantage Chronic Special Needs Plan Boosted Primary Care, Reduced Hospital Use Among Diabetes Patients

“…Recent studies and our analysis of fee-for-service claims data suggest that these patterns persist today. [5][6][7] Our study suggests that CMS may be able to adapt or replicate some of the methods used by the C-SNP program studied here to improve Medicare beneficiaries' care and outcomesnot only for minority patients with diabetes, but potentially for beneficiaries with a broad range of chronic diseases. ▪…”

Impact of Continued Biased Disenrollment from the Medicare Advantage Program to Fee-for-Service

“…Elliott, Haviland, Orr, Hambarsoomian, & Cleary (2011) found more problems getting needed care among MA enrollees than beneficiaries in FFS, and lower ratings of physicians, after case-mix adjustment in 2007. They also found larger disparities in care experiences between sick and healthy beneficiaries in the MA sector.…”