Medicare Advantage enrollees' reports of unfair treatment during health care encounters.

Health affairs scholar Pub Date : 2024-05-29 eCollection Date: 2024-05-01 DOI:10.1093/haschl/qxae063
Megan Mathews, Megan K Beckett, Steven C Martino, Julie A Brown, Nate Orr, Sarah Gaillot, Marc N Elliott
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Abstract

We investigated unfair treatment among 1863 Medicare Advantage (MA) enrollees from 21 MA plans using 2022 survey data (40% response rate) in which respondents indicated whether they were treated unfairly in a health care setting based on any of 10 personal characteristics. We calculated reported unfair treatment rates overall and by enrollee characteristics. Nine percent of respondents reported any unfair treatment, most often based on health condition (6%), disability (3%), or age (2%). Approximately 40% of those reporting any unfair treatment endorsed multiple categories. People who qualified for Medicare via disability reported unfair treatment by disability, age, income, race and ethnicity, sex, sexual orientation, and gender/gender identity more often than those who qualified via age. Enrollees dually eligible for Medicare and Medicaid or eligible for a Low-Income Subsidy (DE/LIS) reported unfair treatment by disability, income, language/accent, race and ethnicity, culture/religion, and sex more often than non-DE/LIS enrollees. Compared with White respondents, racial and ethnic minority respondents more often reported unfair treatment by race and ethnicity, language/accent, culture/religion, and income. Female respondents were more likely than male respondents to report unfair treatment based on age and sex.

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医疗保险优势计划参保者关于在就医过程中受到不公平待遇的报告。
我们利用 2022 年的调查数据(回复率为 40%)调查了 21 个医疗保险计划的 1863 名医疗保险优势计划(MA)参保者所受到的不公平待遇。我们计算了报告的总体不公平待遇率和按参保者特征分列的不公平待遇率。9%的受访者表示受到过任何不公平待遇,最常见的原因是健康状况(6%)、残疾(3%)或年龄(2%)。在报告任何不公平待遇的受访者中,约 40% 的人认可多个类别。与通过年龄获得医疗保险资格的人相比,通过残疾、年龄、收入、种族和民族、性别、性取向和性别/性别认同获得医疗保险资格的人更经常报告受到不公平待遇。同時符合 Medicare 和 Medicaid 資格或符合低收入補助 (DE/LIS) 資格的參加者,比未符合 DE/LIS 資格的參加者更常因殘障、收入、語言/口音、種族和民族、文化/宗教及性別而受到不公平待遇。与白人受访者相比,少数种族和少数民族受访者更经常报告在种族和民族、语言/口音、文化/宗教和收入方面受到不公平待遇。女性受访者比男性受访者更有可能报告因年龄和性别而受到的不公平待遇。
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