HomeHealthOIG says Medicare race data is inaccurate and hinders health disparities assessments...

OIG says Medicare race data is inaccurate and hinders health disparities assessments | NEWSRUX

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There are vital inaccuracies in Medicare information on race and ethnicity, which is very troublesome on condition that the Facilities for Medicare and Medicaid Providers is seeking to gather such information from suppliers and payers, in keeping with the Division of Well being and Human Providers’ 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 flexibility to evaluate well being disparities. Restricted race and ethnicity classes and lacking data contribute to inaccuracies within the enrollment information.

Though using an algorithm improves the present information to some extent, it falls in need of self-reported information, OIG stated. 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 numerous racial and ethnic teams have introduced well being disparities to the forefront, spurring the OIG to conduct the examine. Individuals of coloration have been discovered to expertise disparities in areas similar to entry and care high quality, which might have vital destructive implications for his or her well being.

CMS has made advancing well being fairness a high precedence below the Biden Administration, and a part of that objective entails making certain 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 properties. 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 accumulating race and ethnicity information as a benchmark.


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

To that finish, OIG beneficial 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 suggestion, however concurred with the opposite three suggestions.

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

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