New research suggests that Medicare Advantage plans may be linked to greater racial disparity in readmissions.
A study team analyzed data on patients who underwent surgery in New York in 2013 and found that black Medicare patients were 33% more likely than whites to be readmitted to the hospital. However, the rate jumped dramatically for patients enrolled in Medicare Advantage plans; black patients were 64% more likely to be readmitted than whites, according to the study, which was published in Health Affairs.
The researchers limited their data pool to patients aged 65 or older who underwent one of six major surgical procedures: isolated coronary artery bypass graft, pulmonary lobectomy, endovascular repair of abdominal aortic aneurysm, open repair of abdominal aortic aneurysm, colectomy and hip replacement.
“Our findings suggest that the risk-reduction strategies adopted by Medicare Advantage plans have not succeeded in lowering the markedly higher rates of readmission for black patients compared to white patients,” the researchers, led by a team at the University of Rochester School of Medicine and Dentistry, concluded. "Future qualitative research is necessary to understand which specific managed care approaches may be effective in reducing 30-day readmissions for white and black beneficiaries, and why existing Medicare Advantage plans do not seem to be successful in reducing racial disparity in 30-day surgical readmissions."
Racial disparities in healthcare are well documented. Minority patients are more likely to miss out on effective medical treatments than white patients, and they are more likely to be treated with an excessive amount of ineffective treatments.
Minority patients may also face financial disparities; a recent study found that price markups were common in the emergency department, but especially high for minorities and the uninsured.
But providers are not unified on the best approach to reducing care disparities. Last year the Centers for Medicare & Medicaid Services launched a multipronged approach and 32 organizations will pilot a new community health model under CMS. Genetic research has also been eyed as a possible solution.