CMS report details health disparities among Medicare Advantage enrollees

Black, Indigenous and Alaska Native patients experienced the most significant disparities in clinical care among Medicare Advantage enrollees last year, according to a report from the Centers for Medicare and Medicaid Services and the RAND Corp.

The CMS Office of Minority Health and the consulting company analyzed information from the Healthcare Effectiveness Data and Information Set (HEDIS) and the Consumer Assessment of Healthcare Providers and Systems (CAHPS) for the study, which compares clinical data and patient satisfaction surveys across demographics.

Black, American Indian and Alaska Native enrollees ranked lowest on clinical measures, while Asian American and Pacific Islander beneficiaries reported the worst customer service experiences, according to the report, which published Thursday.

American Indian and Alaska Native enrollees ranked lowest among all demographic groups for breast cancer screenings, respiratory conditions and diabetes care.

Black enrollees were less likely to receive follow-up care after emergency department visits for mental and behavioral health events than other populations, the report shows. These patients also faced the most adverse prescribing practices, with clinicians more likely to dispense medications with significant side effects to Black people.

Researchers determined that gender parity in clinical care measures persisted across racial and ethnic groups, except among Black enrollees. Half of Black men compared to one-third of Black women fell below average on the 28 clinical measures included in HEDIS. Low ratings for managing diabetes, rheumatoid arthritis and behavioral health among Black men drove the gender disparity.

Asian American, Native Hawaiian and Pacific Islander Medicare Advantage enrollees reported the worst patient experiences and ranked below average for six of seven CAHPS metrics. Disparities in scheduling and care coordination were the most significant.

White, American Indian and Alaska Native enrollees were within the national average for all seven patient satisfaction measures. White people experienced the most manageable time scheduling appointments and receiving care promptly, while Hispanic enrollees reported the highest customer service satisfaction. American Indian and multiracial enrollees were more likely to say their doctors communicated well than people from other groups.