Differences in Receipt of Three Preventive Health Care Services by Race/Ethnicity in Medicare Advantage Plans: Tracking the Impact of Pay for Performance, 2010 and 2013

Details

• Journal Article:
  Preventing Chronic Disease (PCD)
• Personal Author:
  Jung, Daniel H. ; Palta, Mari ; Smith, Maureen ; Oliver, Thomas R. ; DuGoff, Eva H.
• Description:
  Introduction
  
  In 2012, the Centers for Medicare and Medicaid Services (CMS) introduced the Quality Bonus Payment Demonstration, a pay-for-performance (P4P) program, into Medicare Advantage plans. Previous studies documented racial/ethnic disparities in receipt of care among participants in these plans. The objective of this study was to determine whether P4P incentives have affected these disparities in Medicare Advantage plans.
  
  Methods
  
  We studied 411 Medicare Advantage health plans that participated in the Medicare Health Outcome Survey in 2010 and 2013. Preventive health care was defined as self-reported receipt of health care provider communication or treatment to reduce risk of falling, improve bladder control, and monitor physical activity among individuals reporting these problems. Logistic regression stratified by health care plan was used to examine racial/ethnic disparities in receipt of preventive health care before and after the introduction of the P4P program in 2012.
  
  Results
  
  We found similar racial/ethnic differences in receipt of preventive health care before and after the introduction of P4P. Blacks and Asians were less likely than whites to receive advice to improve bladder control and more likely to receive advice to reduce risk of falling and improve physical activity. Hispanics were more likely to report receiving advice about all 3 health issues than whites. After the introduction of P4P, the gap decreased between Hispanics and whites for improving bladder control and monitoring physical activity and increased between blacks and whites for monitoring physical activity.
  
  Conclusion
  
  Racial/ethnic differences in receipt of preventive health care are not always in the expected direction. CMS should consider developing a separate measure of equity in preventive health care services to encourage health plans to reduce gaps among racial/ethnic groups in receiving preventive care services.
  
  
• Subjects:
  Aged Aged, 80 And Over Female Health Services Accessibility Health Services Research Humans Logistic Models Male Medicare Part C Population Groups Preventive Health Services Reimbursement, Incentive Socioeconomic Factors

  More +
• Source:
  Prev Chronic Dis. 13.
• DOI:
  http://dx.doi.org/10.5888/pcd13.160047
• ISSN:
  1545-1151
• Pubmed ID:
  27609303
• Pubmed Central ID:
  PMC5027847
• Document Type:
  Journal Article
• Name as Subject:
  Centers for Medicare and Medicaid Services (U.S.) ; Centers for Medicare and Medicaid Services (U.S.)
• Place as Subject:
  United States
• Volume:
  13
• Collection(s):
  Preventing Chronic Disease
• Main Document Checksum:
  urn:sha-512:9727937d8772c053e81dc77118aefa3658398592072c590fe540d2991d8f8776077d5668bfc980852548269fbb3d2222e4bf42780e4f26e94a84529223cdfa4e
• Download URL:
  https://stacks.cdc.gov/view/cdc/42557/cdc_42557_DS1.pdf
• File Type:
  [PDF - 329.49 KB ]