May 3, 2017
Published in: Centers for Medicare & Medicaid Services website (2020)
Posted on RAND.org on September 17, 2021
This report describes the quality of health care received in 2018 by Medicare beneficiaries enrolled in Medicare Advantage (MA) plans nationwide (31.6 percent of all Medicare beneficiaries). The report highlights racial and ethnic differences in health care experiences and clinical care, compares quality of care for women and men, and looks at racial and ethnic differences in quality of care among women and men separately. This 2020 report is the fifth in a series of reports that are updated annually.
The report is based on an analysis of two sources of information. The first source is the Medicare Consumer Assessment of Healthcare Providers and Systems (CAHPS®) survey, which is conducted annually by the Centers for Medicare & Medicaid Services (CMS) and focuses on the health care experiences (e.g., ease of getting needed care, how well providers communicate, and getting needed prescription drugs) of Medicare beneficiaries across the nation. The second source of information is the Healthcare Effectiveness Data and Information Set (HEDIS®). HEDIS is composed of information collected from medical records and administrative data on the clinical quality of care that Medicare beneficiaries receive for a variety of medical issues, including diabetes, cardiovascular disease, and chronic lung disease. A comprehensive list of the seven patient experience and 44 clinical care measures included in this report appears on pp. xiv–xv. Scores on CAHPS measures are case-mix adjusted, as described in the appendix. HEDIS measures are not case-mix adjusted.