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

@article{Li2017MedicareAA,
  title={Medicare Advantage Associated With More Racial Disparity Than Traditional Medicare For Hospital Readmissions.},
  author={Yue Li and Xi Cen and Xueya Cai and Caroline P Thirukumaran and Jie Zhou and Laurent G Glance},
  journal={Health affairs},
  year={2017},
  volume={36 7},
  pages={
          1328-1335
        }
}
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… 
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References

SHOWING 1-10 OF 21 REFERENCES
Analysis Of Medicare Advantage HMOs compared with traditional Medicare shows lower use of many services during 2003-09.
TLDR
It is suggested that overall, Medicare Advantage HMO enrollees might use fewer services and be experiencing more appropriate use of services than enrollees in traditional Medicare.
Disparities in Surgical 30-Day Readmission Rates for Medicare Beneficiaries by Race and Site of Care
TLDR
Among Medicare beneficiaries, black patients were more likely to be readmitted after hospitalization for surgical procedures, and racial disparities were mediated in part by poverty.
Medicare's Hospital Readmissions Reduction Program in Surgery May Disproportionately Affect Minority-serving Hospitals.
TLDR
Minority-serving hospitals would disproportionately bear the burden of readmission penalties if expanded to include cardiac surgery and may have a profound impact on these hospitals' ability to care for disadvantaged patients.
Complex Medicare advantage choices may overwhelm seniors--especially those with impaired decision making.
TLDR
Simplifying choices in Medicare Advantage could improve beneficiaries' enrollment decisions, strengthen value-based competition among plans, and extend the benefits of choice to seniors with impaired cognition.
Hospital readmission rates in Medicare Advantage plans.
TLDR
A benchmark for tracking readmission rates among patients enrolled in Medicare's private comprehensive Medicare Advantage plans is computed using data from a commercial registry and substantial differences in the risk-adjusted rates of hospital readmission among Medicare FFS and MA patients are measured.
Black patients more likely than whites to undergo surgery at low-quality hospitals in segregated regions.
TLDR
Using national Medicare data for all patients who underwent one of three high-risk surgical procedures in 2005-08, it was found that black patients actually tended to live closer to higher-quality hospitals than white patients did but were 25-58 percent more likely than whites to receive surgery at low- quality hospitals.
How successful is Medicare Advantage?
TLDR
Medicare policies regarding lock-in provisions and risk adjustment that were adopted in the mid-2000s have mitigated the adverse selection problem previously plaguing MA, and available measures suggest that, on average, MA plans offer care of equal or higher quality and for less cost than traditional Medicare (TM).
Association between Medicare Advantage plan star ratings and enrollment.
TLDR
Star ratings were less strongly associated with enrollment for black, rural, low-income, and the youngest beneficiaries, suggesting Medicare's 5-star rating program for Medicare Advantage is associated with beneficiaries' enrollment decisions.
Variation in surgical-readmission rates and quality of hospital care.
TLDR
Hospitals with high surgical volume and low surgical mortality have lower rates of surgical readmission than other hospitals, including adherence to surgical process measures, procedure volume, and mortality.
...
...