OIG says Medicare race information is inaccurate and hinders well being disparities assessments

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There are important inaccuracies in Medicare information on race and ethnicity, which is particularly troublesome provided that the Facilities for Medicare and Medicaid Companies is seeking to acquire such information from suppliers and payers, in response to the Division of Well being and Human Companies’ Workplace of the Inspector Basic.

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

This inaccurate information, the federal company claimed, limits the power to evaluate well being disparities. Restricted race and ethnicity classes and lacking data contribute to inaccuracies within the enrollment information.

Though the usage of an algorithm improves the prevailing information to some extent, it falls in need of self-reported information, OIG mentioned. And Medicare’s enrollment information on race and ethnicity are inconsistent with federal information assortment requirements, which inhibits the work of figuring out and enhancing well being disparities inside the Medicare inhabitants.


The disparate impacts of the COVID-19 pandemic on varied racial and ethnic teams have introduced well being disparities to the forefront, spurring the OIG to conduct the examine. Folks of colour have been discovered to expertise disparities in areas equivalent to entry and care high quality, which may have important damaging implications for his or her well being.

CMS has made advancing well being fairness a prime precedence underneath the Biden Administration, and a part of that aim entails guaranteeing that Medicare is ready to assess disparities – which hinges on the standard of the underlying race and ethnicity information.

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

The company assessed the accuracy of Medicare’s enrollment race and ethnicity information for various teams by evaluating them to self-reported information for a subset of beneficiaries who reside in nursing houses. Race and ethnicity information that’s self-reported is taken into account essentially the most correct.

OIG additionally assessed the adequacy of Medicare’s information utilizing the Federal requirements for amassing race and ethnicity information as a benchmark.


A number of suggestions had been issued within the report. For one, OIG mentioned that CMS ought to enhance its race and ethnicity information – a major endeavor, but in addition a urgent want.

To that finish, OIG really helpful that CMS:

  • develop its personal supply of race and ethnicity information.
  • use self-reported race and ethnicity data to enhance information for present beneficiaries.
  • develop a course of to make sure that the information is as standardized as potential.
  • educate beneficiaries about CMS’s efforts to enhance race and ethnicity data.

CMS didn’t explicitly concur with the primary advice, however concurred with the opposite three suggestions.

Twitter: @JELagasse
E mail the author: [email protected]

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