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


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There are significant inaccuracies in Medicare data on race and ethnicity, which is especially troublesome given that the Centers for Medicare and Medicaid Services is looking to collect such data from providers and payers, according to the Department of Health and Human Services’ Office of the Inspector General.

Medicare’s enrollment race and ethnicity data are less accurate for some groups, particularly for beneficiaries identified as American Indian/Alaska Native, Asian/Pacific Islander or Hispanic, the OIG found.

This inaccurate data, the federal agency claimed, limits the ability to assess health disparities. Limited race and ethnicity categories and missing information contribute to inaccuracies in the enrollment data.

Although the use of an algorithm improves the existing data to some extent, it falls short of self-reported data, OIG said. And Medicare’s enrollment data on race and ethnicity are inconsistent with federal data collection standards, which inhibits the work of identifying and improving health disparities within the Medicare population.


The disparate impacts of the COVID-19 pandemic on various racial and ethnic groups have brought health disparities to the forefront, spurring the OIG  to conduct the study. People of color have been found to experience disparities in areas such as access and care quality, which can have significant negative implications for their health.

CMS has made advancing health equity a top priority under the Biden Administration, and part of that goal involves ensuring that Medicare is able to assess disparities – which hinges on the quality of the underlying race and ethnicity data.

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

The agency assessed the accuracy of Medicare’s enrollment race and ethnicity data for different groups by comparing them to self-reported data for a subset of beneficiaries who reside in nursing homes. Race and ethnicity data that are self-reported are considered the most accurate.

OIG also assessed the adequacy of Medicare’s data using the Federal standards for collecting race and ethnicity data as a benchmark.


Several recommendations were issued in the report. For one, OIG said that CMS should improve its race and ethnicity data – a significant undertaking, but also a pressing need.

To that end, OIG recommended that CMS develop its own source of race and ethnicity data; use self-reported race and ethnicity information to improve data for current beneficiaries; develop a process to ensure that the data is as standardized as possible; and educate beneficiaries about CMS’s efforts to improve the race and ethnicity information.

CMS did not explicitly concur with the first recommendation and concurred with the other three recommendations.

Twitter: @JELagasse
Email the writer: [email protected]


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