Racial/Ethnic Disparities in Medicare Beneficiaries' Carecoordination Experiences

Published in: Medical Care, v. 54, no. 8, Aug. 2016, p 765-771

Posted on RAND.org on July 25, 2016

by Steven Martino, Marc N. Elliott, Katrin Hambarsoomian, Robert Weech-Maldonado, Sarah J. Gaillot, Samuel C. Haffer, Ron D. Hays

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Background

Little is known about racial/ethnic differences in the experience of care coordination. To the extent that they exist, such differences may exacerbate health disparities given the higher prevalence of some chronic conditions among minorities.

Objective

To investigate the extent to which racial/ethnic disparities exist in the receipt of coordinated care by Medicare beneficiaries.

Subjects

A total of 260,974 beneficiaries who responded to the 2013 Medicare Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey.

Methods

We fit a series of linear, case-mix adjusted models predicting Medicare CAHPS measures of care coordination from race/ethnicity.

Results

Hispanic, black, and Asian/Pacific Islander (API) beneficiaries reported that their personal doctor had medical records and other relevant information about their care significantly less often than did non-Hispanic white beneficiaries (-2 points for Hispanics, -1 point for blacks, and -4 points for APIs on a 100-point scale). These 3 groups also reported significantly greater difficulty getting timely follow-up on test results than non-Hispanic white beneficiaries (-9 points for Hispanics, -1 point for blacks, -5 points for APIs). Hispanic and black beneficiaries reported that help was provided in managing their care significantly less often than did non-Hispanic white beneficiaries (-2 points for Hispanics, -3 points for blacks). API beneficiaries reported that their personal doctor discussed their medications and had up-to-date information on care from specialists significantly less often than did non-Hispanic white beneficiaries (-2 and -4 points, respectively).

Discussion

These results suggest a need for efforts to address racial/ethnic disparities in care coordination to help ensure high-quality care for all patients. Public reporting of plan-level performance data by race/ethnicity may also be helpful to Medicare beneficiaries and their advocates.

Research conducted by

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