Medicare Advantage Is Closing the Health Disparities Gap for Seniors

By Mary Beth Donahue

The Centers for Disease Control and Prevention (CDC) states it plainly: “racial and ethnic minority groups, throughout the United States, experience higher rates of illness and death … when compared to their white counterparts.”

Those who doubt the agency’s assertion need only look at the 2021 National Healthcare Quality and Disparities report. More than 60 years after the onset of the civil rights movement, the report finds that Black adults are more than eight times as likely to be diagnosed with HIV, more than five times as likely to be hospitalized with hypertension, and 3.5 times as likely to be diagnosed with end-stage renal disease as white adults.

Likewise, the report found that American Indian, Latino, and Asian populations received worse care than white populations on 40%, 36%, and 30%, respectively, of quality measures.

We know that Medicare Advantage has never been immune from the disparities that reach every part of the health care system and society as a whole. At Better Medicare Alliance, we have sought to tackle these challenges head on, owning our responsibility to be a force for positive change.

In 2019, we assembled a first-of-its-kind convening on Medicare Advantage’s role in addressing health disparities, hearing from leaders of the NAACP, the Congressional Black Caucus, National Minority Quality Forum, and others. That convening gave way to a groundbreaking report that captured the input of attendees and has guided our work in the years since.

Data shows us that Medicare Advantage is already serving an outsized share of minority beneficiaries: 53% of Latino Medicare beneficiaries make an active choice for Medicare Advantage, as do 49% of Black beneficiaries. What’s more, enrollment in Medicare Advantage among minority beneficiaries grew 111% from 2013 to 2019 alone.

This means that minority seniors see benefit in Medicare Advantage for themselves. It also means that Medicare Advantage cannot shrink back from a leadership role in remedying inequities in health care.

We know there is progress to celebrate. For example, research from ATI Advisory finds that Black Medicare Advantage beneficiaries see an average of $1,270 a year in cost savings compared to fee-for-service (FFS) Medicare, while Latino beneficiaries save an average of $1,113.

And, as the COVID-19 pandemic persists – disproportionately impacting seniors of color – survey data finds that Medicare Advantage beneficiaries saw lower COVID-19 hospitalization and mortality rates, compared to FFS Medicare.

These achievements led the National Hispanic Medical Association, the National Medical Association, and the Asian and Pacific Islander American Health Forum to laud Medicare Advantage as a “proven” coverage option that will “address the unique needs of a diverse beneficiary population, improve health outcomes, and advance health equity.”

Now, a new report commissioned by the Centers for Medicare & Medicaid Services and conducted by the experts at RAND adds to the body of evidence on how Medicare Advantage is working to close the disparities gap.

While the 101-page report is largely technical in nature, it notes several encouraging trends. For example, the study finds “substantial reductions” in inequities for Black and Latino beneficiaries on access to the annual flu vaccine. This complements separate research from Avalere Health which finds that Medicare Advantage beneficiaries are 11% more likely to receive the flu vaccine than those enrolled in FFS Medicare.

Likewise, Asian American and Pacific Islander (AAPI) Medicare Advantage beneficiaries saw significant improvement in access to diabetic eye exams over the years measured in the report: in 2009, 75.9% of AAPI Medicare Advantage beneficiaries with diabetes had an eye exam in the last year. By 2018, that figure rose to 85.5%.

The CMS report goes on to find “substantial progress in the reduction of inequities in the patient experience for Black beneficiaries” and “substantial improvement for Black and Hispanic beneficiaries in the area of clinical care.”

Ultimately, the study concluded that “further investigation is needed to understand the reason for the large improvements in care” that occurred in many of these minority cohorts, adding that “lessons from such an investigation could potentially be applied to ensure continued progress toward greater health equity for all beneficiaries.”

We at Better Medicare Alliance heartily agree. As CMS’ report also notes – and as each of us knows – there is more to be done. The work of addressing health disparities and eradicating the longstanding stains of racism in health care continues, but Medicare Advantage is up to the task.

Mary Beth Donahue is the President and CEO of Better Medicare Alliance.