Medicare managed care and primary care quality: examining racial/ethnic effects across states.

The study assesses the role of Medicare Advantage (MA) plans in providing quality primary care in comparison to FFS Medicare in three states, New York, California, Florida, across three racial ethnic groups. The performance is measured in terms of providing better quality primary care, as defined by lowering the risks of preventable hospital admissions. Using 2004 hospital discharge data (HCUP-SID) of Agency for Healthcare Research and Quality for three states, a multivariate cross sectional design is used with individual admission as the unit of analysis. The study found that MA plans were associated with lower preventable hospitalizations relative to marker admissions. The benefit also spilled over to different racial and ethnic subgroups and in some states, e.g. CA and FL, MA enrollment was associated with significantly lower odds of minority admissions than of white admissions. These results may indicate a potentially favorable role of MA plans in attenuating racial/ethnic inequalities in primary care in some states.