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Study Reveals Medicaid Disparities


In managed care plans, minority group members report lesser care than white enrollees.

To ensure equity in Medicaid managed care health coverage, there is a need for accurate, recent data on how plans perform for members of different racial and ethnic groups. When Brown University researchers analyzed data on care experiences stratified by racial and ethnic identity, they found that members of minority groups reported significantly worse care experiences compared with white enrollees.

The disparities were largest when the groups were enrolled in the same Medicaid managed care plan.

“Medicaid managed care plans have a responsibility to detect and reduce disparities in health care among their enrollees,” says senior author Amal Trivedi, MD, MPH, a professor of medicine and of health services, policy, and practice. “Our findings indicate that Medicaid plans should collect systematic data on racial and ethnic disparities in patient experiences, and then implement interventions and track progress in eliminating these disparities.”

Measuring care experiences is a way to assess how the plans are working for individual enrollees and include their perspectives, the researchers say.

“What’s exciting about this study is that it incorporates the patient’s voice, through care experience measurements, to help researchers understand the barriers to access,” says lead study author Kevin Nguyen, an investigator in the Department of Health Services, Policy, and Practice at the Brown School of Public Health. “It also assesses racial and ethnic disparities between different plans as well as within the same plan. This distinction has important implications for how such disparities are addressed.”

The study was published in the February issue of Health Affairs.

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