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

Photograph: FG Commerce/Getty Photos

There are important inaccuracies in Medicare data on race and ethnicity, which is particularly troublesome on condition that the Facilities for Medicare and Medicaid Companies is seeking to accumulate such data from suppliers and payers, based on the Division of Health and Human Companies’ Workplace of the Inspector Normal.

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

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

Though using an algorithm improves the present data to some extent, it falls in need of self-reported data, OIG mentioned. And Medicare’s enrollment data on race and ethnicity are inconsistent with federal data assortment requirements, which inhibits the work of figuring out and enhancing health disparities throughout the Medicare inhabitants.


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

CMS has made advancing health fairness a prime precedence beneath the Biden Administration, and a part of that purpose includes guaranteeing that Medicare is capable of assess disparities – which hinges on the standard of the underlying race and ethnicity data.

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

The company assessed the accuracy of Medicare’s enrollment race and ethnicity data for various teams by evaluating them to self-reported data for a subset of beneficiaries who reside in nursing properties. Race and ethnicity data that is self-reported is thought of probably the most correct.

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


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

To that finish, OIG really useful that CMS:

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

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

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

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