Medicare Advantage Associated With More Racial Disparity Than Traditional Medicare For Hospital Readmissions

Published in: Health Affairs, Volume 36, Number 7 (July 2017), pages 1328-1335. doi: 10.1377/hlthaff.2016.1344

Posted on RAND.org on July 26, 2017

by Yue Li, Xi Cen, Xueya Cai, Caroline P. Thirukumaran, Jie Zhou, Laurent G. Glance

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We compared racial disparities in thirty-day readmissions between traditional Medicare and Medicare Advantage beneficiaries who underwent one of six major surgeries in New York State in 2013. We found that Medicare Advantage was associated with greater racial disparity, compared to traditional Medicare. After controlling for patient, hospital, and geographic characteristics in a propensity score based approach, we found that in traditional Medicare, black patients were 33 percent more likely than white patients to be readmitted, whereas in Medicare Advantage, black patients were 64 percent more likely than white patients to be readmitted. Our findings suggest that the risk-reduction strategies adopted by Medicare Advantage plans have not been successful in lowering the markedly higher rate of readmission among black patients, compared to white patients.

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