Table 3.
Provider Discrimination—Difference in Vaccination Rates among Beneficiaries Who Had a Medical Encounter with the Same Providers during Vaccination Weeks
| White | African American | Hispanic | |||||
|---|---|---|---|---|---|---|---|
| All Races | Unadjusted | Adjusted‡ | Unadjusted | Adjusted‡ | Unadjusted | Adjusted‡ | |
| Beneficiaries who had a medical encounter with the same providers during vaccination weeks† (n) | 1,488 | 1,127 | 278 | 83 | |||
| Number of these beneficiaries who did not receive vaccination from another provider | 974 | 726 | 194 | 54 | |||
| Percent of these beneficiaries who received a Medicare-paid influenza vaccination (n) | 62.8% (612) | 70.4% (511) | 67.4% | 35.1%*** (68) | 44.1%*** | 61.1% (33) | 70.1% |
| Percent of beneficiaries vaccinated on a “vaccination-initiated” encounter§ (n) | 34.4% (335) | 42.0% (305) | 38.9% | 8.2%*** (16) | 12.6%*** | 25.9%* (14) | 35.1% |
| Percent of beneficiaries vaccinated as an adjunct to another medical service (n) | 28.4% (277) | 28.4% (206) | 28.5% | 26.8% (52) | 26.4% | 35.2% (19) | 34.0% |
| Median reimbursement on Part B claims for medical encounters during influenza vaccination weeks (interquartile range)¶ | $26.6 | $29.4 | $29.8 | $21.2*** | $20.8*** | $24.1*** | $23.8* |
| (18.1, 42.1) | (19.6, 50.2) | (28.5, 31.2) | (14.2, 30.3) | (18.2, 23.5) | (17.7, 28.5) | (19.1, 28.5) | |
| Median number of line-items (separate procedures) on Part B claims for medical encounters during influenza vaccination weeks¶ | 2 | 2 | 2.1 | 1*** | 1.2*** | 1*** | 1.5*** |
| (1, 3) | (1, 3) | (2.03, 2.16) | (1, 2) | (1.10, 1.36) | (1, 2) | (1.28, 1.75) | |
p<0.001.
Includes nonwhite beneficiaries who had a medical encounter with their usual provider during vaccination weeks, and white beneficiaries who also had an encounter with that provider during influenza vaccination weeks.
Adjusted for gender, age, census region of residence, socioeconomic status, supplemental insurance, and risk factors for influenza using logistic regression.
A “vaccination-initiated” encounter is one in which the only claim for the beneficiary on that day is a claim for an influenza vaccination or influenza plus pneumococcal vaccination (92 percent of such claims), or the first-listed diagnosis on the claim indicates influenza vaccination (8 percent of such claims).
Note: p-values are based on a Wilcoxon' signed rank test. Adjusted values are from a median (quintile) regression.