Gender Differences in Patient Experience Across Medicare Advantage Plans |
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| Institution: | 1. RAND Corporation, Santa Monica, California;2. Carnegie Mellon University, Pittsburgh, Pennsylvania;3. RAND Corporation, Pittsburgh, Pennsylvania;4. Department of Health Services Administration, University of Alabama at Birmingham, Birmingham, Alabama;5. Centers for Medicare and Medicaid Services, Baltimore, Maryland;1. University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania;2. Departments of Obstetrics and Gynecology and Health Services, University of Washington, Seattle, Washington;3. Center for Veteran-Centered and Value-Driven Care, VA Puget Sound Health Care System, Seattle, Washington;4. Center for Health Equity Research and Promotion, VA Pittsburgh Health Care System, Pittsburgh, Pennsylvania;5. Center for Research on Health Care, University of Pittsburgh, Pittsburgh, Pennsylvania;1. Advancing New Standards in Reproductive Health (ANSIRH), Bixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, Oakland, California;2. American College of Obstetricians and Gynecologists, Washington, District of Columbia;1. Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington;2. Departments of Obstetrics and Gynecology and Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois;1. Department of Health Services Management & Policy, East Tennessee State University, College of Public Health, Johnson City, Tennessee;2. Department of Community & Behavioral Health, East Tennessee State University, College of Public Health, Johnson City, Tennessee |
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| Abstract: | BackgroundMedicare beneficiaries annually select fee-for-service Medicare or a private Medicare insurance (managed care) plan; information about plan performance on quality measures can inform their decisions. Although there is drill-down information available regarding quality variation by race and ethnicity, there remains a dearth of evidence regarding the extent to which care varies by other key beneficiary characteristics, such as gender. We measured gender differences for six patient experience measures and how gender gaps differ across Medicare plans.MethodsWe used data from 300,979 respondents to the 2015–2016 Medicare Advantage Consumer Assessment of Healthcare Providers and Systems surveys. We fit case mix–adjusted linear mixed-effects models to estimate gender differences and evaluate heterogeneity in differences across health plans.ResultsNationally, women's experiences were better than men's (p < .05) by 1 percentage point on measures involving interactions with administrative staff (+1.6 percentage point for customer service) and timely access to care (+1.1 percentage point for getting care quickly), but worse on a measure that may involve negotiation with physicians (getting needed care). Gender gaps varied across plans, particularly for getting care quickly and getting needed care, where plan-level differences of up to 5 to 6 percentage points were observed.ConclusionsAlthough the average national differences in patient experience by gender were generally small, gender gaps were larger in some health plans and for specific measures. This finding indicates opportunities for health plans with larger gender gaps to implement quality improvement efforts. |
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