Quality of Care Stratified Report Just Released: Disparities in Health Care in Medicare Advantage Associated with Dual Eligibility or Eligibility for a Low-Income Subsidy

 

Newly Released Quality of Care Report Today, the Centers for Medicare & Medicaid Services, Office of Minority Health (CMS OMH) released a report detailing the quality of care received by people enrolled in Medicare Advantage (MA): Disparities in Health Care in Medicare Advantage Associated with Dual Eligibility or Eligibility for a Low-Income Subsidy. This report is the first of its kind and builds on the racial, ethnic, and gender stratified reports released by CMS OMH since 2016 and the rural-urban stratified reports released by CMS OMH since 2018. This latest report adds to existing information from CMS on stratified reporting in Medicare Advantage to describe differences in clinical care by dual eligibility for Medicare and Medicaid or eligibility for a Low-Income Subsidy (DE/LIS status) and looks at how differences based on DE/LIS status vary by race and ethnicity and between rural and urban areas. The analysis uses 39 measures from the Healthcare Effectiveness Data and Information Set (HEDIS), which is based on medical records and administrative data on the technical quality of care that Medicare beneficiaries receive for a variety of medical issues, including diabetes, cardiovascular disease, and chronic lung disease. Findings in the report demonstrate that overall, dual and Low-Income Subsidy beneficiaries often received worse clinical care than non-DE/LIS beneficiaries (deficits were largest in follow-up after hospitalization for mental illness, avoiding potentially harmful drug-disease interactions in elderly patients with dementia and history of falls, and controlling blood pressure among patients with diabetes); the trends for worse clinical care persisted when results were stratified by race and ethnicity, though to a lesser degree for Hispanic beneficiaries. Finally, this analysis revealed more-pronounced disparities in clinical care for DE/LIS beneficiaries in urban than in rural areas. The goal of the report is to increase awareness about disparities in quality of care for dual/Low-income subsidy beneficiaries. We also hope that the diabetes stratified report can serve as the impetus for action by researchers and other key stakeholders to explore the drivers of the identified disparities and develop and implement sustainable solutions. Health care professionals, organizations, researchers, and hospital leaders can utilize this report along with other CMS tools and resources to help raise awareness of health disparities, develop health care interventions for DE/LIS eligible Medicare beneficiaries, and implement quality improvement efforts that improve health equity. To learn more about the CMS Office of Minority Health, visit go.cms.gov/omh.

 

CMS Office of Minority Health  |  Working to Achieve Health Equity Paid for by the US Department of Health and Human Services