Exhibit 4.

Differences in health status, functional status, and access to care after standard risk adjustment

Characteristic	HCC-adjusted difference in health or access measure, % (95% CI)
	Problem accessing care	Fair or poor general health	Fair or poor mental health	Difficulty with an ADL
RTI race and ethnicity
White, non-Hispanic	ref	ref	ref	ref
Black	5.9 (5.3, 6.5)	3.0 (2.3, 3.7)	2.4 (1.7, 3.1)	1.7 (0.9, 2.5)
Hispanic	7.0 (6.1, 7.9)	7.6 (6.5, 8.6)	5.7 (4.9, 6.6)	2.0 (1.1, 2.9)
Education
High school degree or more	ref	ref	ref	ref
No high school degree	4.3 (3.8, 4.8)	10.4 (9.9, 10.9)	8.4 (7.9, 8.8)	4.3 (3.8, 4.8)
Block group measures
Percent without a high school degree	0.3 (0.1, 0.4)	0.3 (0.2, 0.5)	0.2 (0.0, 0.3)	0.3 (0.1, 0.5)
Percent Black	0.9 (0.7, 1.1)	0.8 (0.6, 1.0)	0.4 (0.3, 0.6)	0.8 (0.6, 1.1)
Percent Hispanic	0.8 (0.6, 1.0)	1.5 (1.2, 1.7)	0.9 (0.7, 1.1)	1.3 (1.0, 1.5)

Source: Authors’ analysis of FFS CAHPS survey data, Medicare claims and enrollment data, and American Community Survey data.

Notes: All results are derived from analysis of CAHPS sample. Estimates for each block group measure have been rescaled to reflect a standard deviation change in the measure.