In response to the OIG, Medicare’s race knowledge is inaccurate and hinders the evaluation of well being disparities

In response to the OIG, Medicare’s race knowledge is inaccurate and hinders the evaluation of well being disparities

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There are important inaccuracies in Medicare knowledge on race and ethnicity, which is especially problematic because the Facilities for Medicare and Medicaid Companies search to gather such knowledge from suppliers and payers, based on the Division of Well being’s Workplace of the Inspector and Human Companies Normal.

Medicare’s race and ethnicity disclosures are much less correct for some teams, notably beneficiaries recognized as Native American/Alaska Native, Asian/Pacific Islander, or Hispanic, the OIG discovered.

This inaccurate knowledge, the federal company stated, limits the power to evaluate well being variations. Restricted racial and ethnic classes and lacking info contribute to inaccuracies in enrollment knowledge.

Though utilizing an algorithm improves the present knowledge to some extent, it falls wanting the self-reported knowledge, OIG stated. And Medicare’s race and ethnicity enrollment knowledge doesn’t meet federal knowledge assortment requirements, impeding work to establish and enhance well being disparities inside the Medicare inhabitants.


The differential affect of the COVID-19 pandemic on completely different racial and ethnic teams has introduced well being disparities to the fore, prompting the OIG to conduct the examine. It has been discovered that folks of colour expertise variations in areas corresponding to entry and high quality of care, which may have important adverse impacts on their well being.

CMS has made selling well being fairness a high precedence below the Biden administration, and a part of that objective is making certain Medicare is ready to assess disparities — which relies on the standard of the underlying race and ethnicity knowledge.

The OIG analyzed the race and ethnicity knowledge in Medicare’s enrollment database, the one supply of data for registered beneficiaries. This knowledge, in flip, is derived from Social Safety Administration supply knowledge and the outcomes of an algorithm that CMS applies to the supply knowledge.

The company evaluated the accuracy of Medicare race and ethnicity knowledge for various teams by evaluating it to self-reported knowledge for a subset of beneficiaries dwelling in nursing houses. Self-reported race and ethnicity knowledge is taken into account essentially the most correct.

The OIG additionally evaluated the adequacy of Medicare’s knowledge utilizing federal requirements for the gathering of race and ethnicity knowledge as a benchmark.


A number of suggestions had been made within the report. For one, OIG stated CMS ought to enhance its race and ethnicity knowledge — a big endeavor, but additionally a urgent want.

To this finish, the OIG really useful that CMS develop its personal supply of race and ethnicity knowledge; Use self-reported race and ethnicity info to enhance knowledge for present beneficiaries; develop a course of to make sure knowledge is as standardized as doable; and to coach beneficiaries about CMS’s efforts to enhance race and ethnicity info.

CMS didn’t explicitly agree with the primary suggestion and agreed with the opposite three suggestions.

Twitter: @JELagasse
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