Some Medicare Advantage plans better able to control risk factors

Geographic and racial disparities exist, but high-quality care can break divide

Medicare Advantage members of ethnic backgrounds with high blood pressure, heart disease or diabetes are much less likely than white members to have their blood pressure, cholesterol and blood sugar under control, according to a new study published in the New England Journal of Medicine.

That poses a problem--when these risk factors aren't controlled, they can substantially raise individuals' risk of health complications and increase the need for otherwise unnecessary care. In fact, chronic diseases such as heart disease and diabetes are some of the most preventable health issues in the United States, but they cost more than $2 trillion a year, FierceHealthPayer previously reported.

The study, which analyzed data for about 100,000 Medicare Advantage members between 2006 and 2011, also found that plans in Western states were better able to control the risk factors. There, too, the gap between black and white members was erased.

For example, 74 percent of both blacks and whites in the West had their blood pressure under control. In the Northeast, on the other hand, 60 percent of blacks had good blood pressure levels, compared to 71 percent of whites.

"The 'disappearing disparities' in the West surprised us," lead author John Ayanian, director of the University of Michigan Institute for Healthcare Policy and Innovation, said in a statement. "It's one of a few examples in large populations where we've seen that higher quality of care can eliminate racial disparities in major risk factors."

Within the West, Kaiser Permanente Medicare Advantage plans were more likely to have their members keep blood pressure, cholesterol and blood sugar under control than members in other plans. The study authors noted that Kaiser has spent "considerable effort" to modify these three risk factors.

To learn more:
- access the NEJM study
- read the statement

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