OIG says Medicare race data is inaccurate and hinders health inequality

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There are significant errors in Medicare data on race and ethnicity, which is particularly problematic because Medicare and Medicaid service centers seek to collect such data from providers and providers, according to the Office of the Inspector General of Health and Human Services.

Medicare’s enrollment of race and ethnic information is less accurate for some groups, especially for beneficiaries identified as American Indian / Alaska Native, Asian / Pacific Islander or Hispanic, the OIG found.

This misinformation, the federal agency claims, limits the ability to assess health inequalities. Limited races and ethnic divisions and missing data contribute to errors in enrollment data.

Although the use of an algorithm improves existing data to some extent, it reads less than self-reported data, the OIG said. And Medicare’s enrollment data on race and ethnicity is inconsistent with federal data collection standards, which prevents Medicare from identifying and improving health disparities within the population.

What is the effect?

The unequal impact of the COVID-19 epidemic on different ethnic and racial groups has led to health inequalities, prompting the OIG to conduct studies. People of color have been found to experience discrimination in areas such as access and quality of care, which can have a significant negative impact on their health.

CMS has made the advancement of health equity a top priority under the Biden Administration, and part of that goal is to ensure that Medicare is able to evaluate inequalities – depending on the quality of the underlying race and ethnic data.

OIG has analyzed race and ethnic data in Medicare’s enrollment database, the only source of information for registered beneficiaries. That data is in turn derived from the source data of the Social Security Administration and the results of an algorithm that applies to CMS source data.

The agency assessed the accuracy of Medicare enrollment race and ethnic data for different groups by comparing self-reported data for a subset of beneficiaries living in nursing homes. Self-reported race and ethnic data are considered the most accurate.

The OIG has also assessed the adequacy of Medicare data using federal standards for collecting race and ethnic information as a criterion.

Greater trend

Several recommendations have been made in the report. For one, the OIG says CMS’s race and ethnic information should be improved – a significant initiative, but an important requirement.

To that end, OIG recommends that CMS:

  • Develop own source of race and ethnic information.
  • Use self-reported race and ethnic information to improve data for current beneficiaries.
  • Develop a process to ensure the data is as quality as possible.
  • Educate the beneficiaries about CMS’s efforts to improve race and ethnic information.

CMS did not explicitly agree with the first recommendation, but agreed with the other three.

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