+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Racial and ethnic differences in use of mammography between Medicare Advantage and traditional Medicare

Racial and ethnic differences in use of mammography between Medicare Advantage and traditional Medicare

Journal of the National Cancer Institute 105(24): 1891-1896

Breast cancer is a leading cause of mortality for women in all racial/ethnic groups. We compared use of mammography by race/ethnicity in Medicare health maintenance organizations (HMOs), preferred provider organizations (PPOs), and traditional Medicare. We matched 495 836 women in HMOs and 81 480 women in PPOs who were aged 65 to 69 years during 2009 to women enrolled in traditional Medicare by race/ethnicity, Medicaid eligibility status, and geographic area. We identified mammography use from the Healthcare Effectiveness Data and Information Set for Medicare HMOs and PPOs and from claims data for traditional Medicare with the same specifications. We then compared racial/ethnic differences in rates of mammography in HMOs and PPOs to matched populations in traditional Medicare and estimated differences with z tests. All statistical tests were two-sided. Relative to matched white women, mammography rates were statistically significantly higher for black, Hispanic, and Asian/Pacific Islander women in HMOs (6.1, 5.4, and 0.9 percentage points, respectively; all P ≤ .003) and statistically significantly lower for all three groups in traditional Medicare (3.3, 7.4, and 7.7 percentage points, respectively; all P < .001). Similar improvements in mammography rates also were observed in PPOs among all minority groups relative to traditional Medicare. Higher rates of mammography in HMOs and PPOs were associated with a reversal of racial and ethnic differences observed in traditional Medicare. These differences may be related to lower patient cost-sharing and better systems to promote preventive services in managed care plans, as well as unmeasured characteristics or beliefs of minority women who enroll in these health plans relative to those in traditional Medicare.

Please choose payment method:

(PDF emailed within 0-6 h: $19.90)

Accession: 055340848

Download citation: RISBibTeXText

PMID: 24316600

DOI: 10.1093/jnci/djt333

Related references

Medicare Advantage Associated With More Racial Disparity Than Traditional Medicare For Hospital Readmissions. Health Affairs 36(7): 1328-1335, 2017

Racial And Ethnic Differences In The Attainment Of Behavioral Health Quality Measures In Medicare Advantage Plans. Health Affairs 37(10): 1685-1692, 2018

Differences in Nursing Home Quality Between Medicare Advantage and Traditional Medicare Patients. Journal of the American Medical Directors Association 17(10): 960.E9-960.E14, 2017

Mortality Differences Between Traditional Medicare and Medicare Advantage: A Risk-Adjusted Assessment Using Claims Data. Inquiry 54: 46958017709103, 2017

Differences in Management of Coronary Artery Disease in Patients With Medicare Advantage vs Traditional Fee-for-Service Medicare Among Cardiology Practices. JAMA Cardiology 2019, 2019

Racial/Ethnic Differences in Those Accompanying Medicare Patients to the Doctor: Insights from the 2013 Medicare Current Beneficiary's Survey. Journal of Immigrant and Minority Health 20(4): 776-783, 2017

Medicare Program; Revisions to Payment Policies Under the Physician Fee Schedule and Other Revisions to Part B for CY 2017; Medicare Advantage Bid Pricing Data Release; Medicare Advantage and Part D Medical Loss Ratio Data Release; Medicare Advantage Provider Network Requirements; Expansion of Medicare Diabetes Prevention Program Model; Medicare Shared Savings Program Requirements. Final rule. Federal Register 81(220): 80170-80562, 2016

Health characteristics of Medicare traditional fee-for-service and Medicare Advantage enrollees: 1999-2004 National Health and Nutrition Examination Survey linked to 2007 Medicare data. National Health Statistics Reports 2012(53): 1-12, 2012

Racial and ethnic disparities among enrollees in Medicare Advantage plans. New England Journal of Medicine 371(24): 2288-2297, 2015

Medicare Program; Contract Year 2019 Policy and Technical Changes to the Medicare Advantage, Medicare Cost Plan, Medicare Fee-for-Service, the Medicare Prescription Drug Benefit Programs, and the PACE Program. Final rule. Federal Register 83(73): 16440-16757, 2018

Does Medicare Advantage Reduce Racial Disparity in 30-Day Rehospitalization for Medicare Beneficiaries?. Medical Care Research and Review 75(2): 175-200, 2016

Does the racial/ethnic composition of Medicare Advantage plans reflect their areas of operation?. Health Services Research 49(2): 526-545, 2014

Medicare Advantage, accountable care organizations, and traditional Medicare: synchronization or collision?. Yale Journal of Health Policy, Law, and Ethics 15(1): 37-55, 2015

At least half of new Medicare advantage enrollees had switched from traditional Medicare during 2006-11. Health Affairs 34(1): 48-55, 2017

Prices for physician services in Medicare Advantage versus traditional Medicare. American Journal of Managed Care 24(7): 341-344, 2018