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

OBJECTIVE: To assess the extent to which the racial/ethnic composition of Medicare Advantage (MA) plans reflects the composition of their areas of operation, given the potential incentives created by the Centers for Medicare & Medicaid Services' Quality Bonus Payments for such plans to avoid enrolling racial/ethnic minority beneficiaries. DATA SOURCES/STUDY SETTING: 2009 Medicare Consumer Assessment of Healthcare Providers and Systems (MCAHPS) survey and administrative data from the Medicare Enrollment Database. DATA COLLECTION/EXTRACTION METHODS: We defined each plan's area of operation as all counties in which it had MA enrollees, and we created a matrix of race/ethnicity by plan by county of residence to assess the racial/ethnic distribution of each plan's enrollees in comparison with the racial/ethnic composition of MA beneficiaries in its operational area. PRINCIPAL FINDINGS: There is little evidence that health plans are selectively underenrolling blacks, Latinos, or Asians to a substantial degree. A small but potentially important subset of plans disproportionately serves minority beneficiaries. CONCLUSIONS: These findings provide a baseline profile that will enable crucial ongoing monitoring to assess how the implementation of Quality Bonus Payments may affect MA plan coverage of minority populations.