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Activity Number: 35 - Imputing Race/Ethnicity to Understand Health Care Disparities Among Older Adults
Type: Topic Contributed
Date/Time: Monday, August 3, 2020 : 10:00 AM to 11:50 AM
Sponsor: Social Statistics Section
Abstract #312436
Title: Voluntary Disenrollment from Health Plans Is Higher Among Racial and Ethnic Minorities
Author(s): Marc Elliott*
Companies: RAND
Keywords: disparities; health plan disenrollment; race/ethnicity

Each year about 10% of Medicare Advantage (MA) enrollees voluntarily disenroll from their plans; differential disenrollment may inform efforts to reduce racial and ethnic (r/e) disparities in care. We used enrollment data from 16,770,319 Medicare beneficiaries enrolled in 736 MA plans in 2015 to assess r/e differences in disenrollment. MA r/e data were augmented with surname, address, and other administrative data to calculate probabilities of membership in different r/e groups and logistic regression models estimated overall and within-plan differences. Rates of disenrollment adjusted for beneficiary characteristics were significantly (p< 0.001) higher for Hispanic (+1.2 percentage points [pp]), black (+1.2 pp), and Asian/Pacific Islander (API) beneficiaries (+2.4 pp) than for whites. Within states, minority groups were concentrated in higher-disenrollment plans. More than 70% of the adjusted overall difference between API and white beneficiaries reflected the former’s tendency to disenroll from the same plans at higher rates, whereas most of the differences for black and Hispanic beneficiaries reflected between-plan differences.

Authors who are presenting talks have a * after their name.

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