As protests erupt across the U.S. calling for racial justice and
police reforms, the COVID-19 pandemic continues to bring to light many of the
racial disparities in health care, putting pressure on policymakers and the
industry to take a hard look at health and access inequities.
Meanwhile, CMS's Office of Minority Research in April released a
stratified report highlighting the racial and ethnic differences in health care
experiences and care of Medicare Advantage (MA) enrollees. The data showed that
black members enrolled in MA plans in 2018 received worse clinical care than
white enrollees on 20 out of 44 measures, similar care for 20 and better care
for four. And all minority populations reported experiences with care that were
either worse than or similar to the experiences reported by white enrollees,
including the experience measure for getting appointments and care quickly.
Not getting the proper care when it's needed is a reflection of
the provider network, says John Gorman, chairman and CEO of Nightingale
Partners LLC. "And then when you look at the clinical measures where
there's huge racial disparities, all of those tie back to a lack of culturally
competent physicians serving these populations in a manner that speaks to the
way that they need to access health care," he observes.
John Weis, CEO of Quest Analytics, LLC, predicts that
"there will be a significant impact on practice consolidation" from
the pandemic. "Given the potential risk to providers, we predict that
coming out of COVID, we'll see an uptick in providers that want to minimize
their exposure and consider retirement," he suggests. And with fewer
providers available, "if plans are not prepared, this will drive both
out-of-network utilization and increase health care costs in rural areas."
Dan Mendelson, founder of Avalere Health, suggests that while MA
plans have the tools to address racial disparities, they don't necessarily have
the incentives to prioritize them. "I think Medicare Advantage plans are
uniquely equipped to measure, understand, identify and mitigate disparities….
So, a proactive form of engagement that is focused on disparities can
work," says Mendelson. "One thing that is not there at this point is
any kind of direct incentive to the plans to act."
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