Do Experiences with Medicare Managed Care Vary According to the Proportion of Same-Race/Ethnicity/Language Individuals Enrolled in One's Contract?

Health Services Research
Rebecca Anhang PriceMarc N Elliott

Abstract

To examine whether care experiences and immunization for racial/ethnic/language minority Medicare beneficiaries vary with the proportion of same-group beneficiaries in Medicare Advantage (MA) contracts. Exactly 492,495 Medicare beneficiaries responding to the 2008-2009 MA Consumer Assessment of Healthcare Providers and Systems (CAHPS) Survey. Mixed-effect regression models predicted eight CAHPS patient experience measures from self-reported race/ethnicity/language preference at individual and contract levels, beneficiary-level case-mix adjustors, along with contract and geographic random effects. As a contract's proportion of a given minority group increased, overall and non-Hispanic, white patient experiences were poorer on average; for the minority group in question, however, high-minority plans may score as well as low-minority plans. Spanish-preferring Hispanic beneficiaries also experience smaller disparities relative to non-Hispanic whites in plans with higher Spanish-preferring proportions. The tendency for high-minority contracts to provide less positive patient experiences for others in the contract, but similar or even more positive patient experiences for concentrated minority group beneficiaries, may reflect cultura...Continue Reading

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Citations

May 3, 2018·Southern Medical Journal·Kendall M CampbellJosé E Rodríguez
May 29, 2018·International Journal of Health Services : Planning, Administration, Evaluation·Ola M HaidarRobert Pampalon
Nov 24, 2018·Health Services Research·Anny T FentonMarc N Elliott
Jan 8, 2019·Health Services Research·Denise D QuigleySteven C Martino
Apr 7, 2021·Journal of General Internal Medicine·Layla ParastMarc N Elliott
Oct 2, 2021·Health Services Research·Megan K BeckettMarc N Elliott

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