Black and Latinx enrollees are overrepresented in Medicare Advantage plans, and prior research has found mixed evidence about differences in their satisfaction with health care access and affordability compared to traditional Medicare. Building on this work, Renuka Tipirneni, a faculty member at the Institute for Healthcare Policy and Innovation at the University of Michigan, and LDI Senior Fellow Eric T. Roberts investigated whether Medicare Advantage reduced racial and ethnic disparities in the receipt of preventive care.  

The study analyzed data from a national survey of Medicare beneficiaries and found that Black beneficiaries enrolled in Medicare Advantage reported receiving more preventive services for cardiovascular disease and chronic conditions than those enrolled in traditional Medicare.

White beneficiaries also had higher rates of preventive care use in Medicare Advantage than in traditional Medicare. However, the differences were larger among Black beneficiaries, suggesting that Medicare Advantage may help narrow certain racial disparities in the receipt of preventive care. Despite these relative gains, the study found that Black-white disparities persisted in both traditional Medicare and Medicare Advantage.

Furthermore, although overall preventive care use was somewhat higher in Medicare Advantage, Latinx-white disparities did not differ significantly between the two programs. Latinx beneficiaries had lower use of several of the preventive services than white beneficiaries in both Medicare Advantage and traditional Medicare.

Policy Implications

Medicare Advantage costs taxpayers 22% more per beneficiary than traditional Medicare, and both programs perform similarly on some health care quality measures. Roberts and Tipirneni’s research adds to previous work showing that Medicare Advantage performs slightly better when it comes to the use of some preventive services, but not enough to overcome racial and ethnic disparities in care.

“Although greater use of preventive and chronic disease care in Medicare Advantage modestly narrowed Black-white disparities, gaps in care persisted across both Medicare Advantage and traditional Medicare,” said Roberts. “More research is needed to understand differences in care between Medicare Advantage and traditional Medicare for different groups of people and types of care.”

“It’s important to identify where quality of care differs for patient groups within Medicare Advantage,” added Tipirneni. “Right now, quality is judged using a star rating system that combines results across many people, plans, and regions. This can hide important differences between groups.”

The researchers said that policymakers could monitor disparities at the plan level using tools like the Health Equity Summary Score or surveys that capture patients’ experiences of equitable care.

Policymakers should also think about setting minimum standards for access and quality in Medicare Advantage plans. They noted that narrow provider networks or prior authorization rules may affect minoritized groups more strongly.

“Quality standards need to be enforced at the right level to reduce racial and ethnic disparities in access to high-quality care,” said Tipirneni.

Study Used Self-Reported Data on Preventive Services from Medicare

The researchers used national data from the Medicare Current Beneficiary Survey (MCBS) from 2015 to 2020 to compare racial and ethnic differences in preventive health services and chronic disease care. They compared 44,106 survey responses from people on traditional Medicare who self-reported conditions such as a previous heart attack, angina, atherosclerosis, stroke, congestive heart failure, diabetes, high blood pressure, or high cholesterol with 27,948 observations from people with similar conditions on Medicare Advantage.

Researchers Analyzed Cardiovascular and Diabetes Preventive Services and Created a Summary Index

The researchers compared receipt of guideline-directed preventive health care among Black, white, and Latinx Medicare enrollees. The services included annual wellness visits, blood pressure checks, blood cholesterol checks, influenza and pneumococcal vaccines, colorectal and breast cancer screening, and, for respondents with diabetes, they evaluated hemoglobin A1C checks and eye exams, important parts of diabetes care.

The team created a preventive care index based on the sum of the indicators for blood pressure and cholesterol checks, influenza vaccine, pneumococcal vaccine, and colorectal cancer screening (a 0–5 scale for the number of “yes” responses). These services reflect key aspects of preventive care for all survey participants.

Preventive Index Score Showed Medicare Advantage Enrollees Received More Preventive Services, but Disparities Persisted

Among all groups, Medicare Advantage enrollees received more preventive services. Additionally, Black-white and Latinx-white disparities were smaller among Medicare Advantage than among traditional Medicare enrollees for the preventive care index.

Higher Preventive Care Utilization Among Black Beneficiaries in Medicare Advantage Compared to Traditional Medicare

Black beneficiaries received more preventive care in Medicare Advantage than in traditional Medicare, with notably higher rates of annual wellness visits, vaccinations, cancer screenings, and chronic disease monitoring.

Smaller Black-White Disparities in Some Preventive Care Use Under Medicare Advantage

Black beneficiaries consistently had lower use of several key preventive services compared to white beneficiaries in both Medicare Advantage and traditional Medicare. However, Black-white disparities in preventive care use were generally smaller in Medicare Advantage than in traditional Medicare, especially for blood pressure checks, cholesterol checks, and eye exams.

Latinx Beneficiaries Used Less Preventive Care Than White Beneficiaries in Both Medicare Programs

Latinx beneficiaries enrolled in Medicare Advantage had higher rates of preventive care use compared to those in traditional Medicare, but the differences were not statistically significant. Compared to white beneficiaries, Latinx beneficiaries enrolled in Medicare Advantage and traditional Medicare had lower rates of annual wellness visits, influenza and pneumococcal vaccine, colorectal cancer screening, and hemoglobin A1C tests.

---

The study “Racial and Ethnic Disparities in Satisfaction with Healthcare Access and Affordability in Medicare Advantage vs. Traditional Medicare” was published July 25, 2025 in the Journal of General Internal Medicine by Renuka Tipirneni, Andrei R. Stefanescu, Dominic A. Ruggiero, Alexandra G. Hames, John Z. Ayanian, and Eric T. Roberts.

---

Author

---