Black Medicare patients more likely than whites to be readmitted: Study – CNBC

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A patient is examined by a doctor in Miami, Florida.

Black Medicare patients are being readmitted to hospitals at a much higher rate than are white patients, according to a recent study.

The study, which surveyed New York state residents age 65 and older, is the latest in a series of reports that suggest minorities are getting shortchanged on quality care.

The study in the June issue of Health Affairs compared racial disparities in 30-day readmissions between traditional Medicare and Medicare Advantage beneficiaries who underwent one of six major surgeries in the state in 2013.

Black patients in traditional Medicare were 33 percent more likely than white patients to be readmitted to the hospital within 30 days, according to the study. For Medicare Advantage patients, the likelihood nearly doubled, to 64 percent.

Medicare Advantage is controlled by private insurers rather than the government. The companies take what the government would normally pay for health care and bet that they can treat patients at a lower cost.

The study cited multiple possible factors that could be causing this racial disparity.

One is that black patients are not receiving adequate initial treatment compared with white patients. A different Health Affairs study found that blacks and Hispanics are more likely than whites to get low-value health care, getting both less effective treatment and being over treated with unnecessary, ineffective tests.

Another possibility is that more black patients are going to low-quality hospitals than are whites, the researchers said. Also, black patients could lack access to adequate transitional and ambulatory care after they are discharged, with less appropriate social and community support, and lower health literacy.

The New York study, however, did not shed light on why there is a disparity between traditional Medicare and Medicare Advantage patients. One possibility could be that the profit-incentive private insurers of Medicare Advantage are aggressively managing their patients, by encouraging faster, less adequate — yet cheaper — treatment from doctors, which would cause a higher chance of that patient having to be readmitted.

One of the report’s authors — Yue Li, a professor of health policy at the University of Rochester Medical Center — said that although the study cannot confirm that theory, it could very well be a possibility.

“The short answer is it is possible, but it cannot be confirmed by this study,” said Li. “The finding that the disparities are more evident among the [Medicaid Advantage] group may suggest that the private insurers may have stronger incentives to cut expensive and effective services, which may hurt vulnerable patients more.”

“Our findings of persistent racial disparities in surgical readmissions despite the national trend are troubling, and they may suggest that recent readmission reduction efforts were broadly targeted,” the researchers said.

The industry association America’s Health Insurance Plans did not immediately respond to a CNBC request for comment.

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