OIG says Medicare race data is inaccurate and hinders assessment of health disparities

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There are significant inaccuracies in Medicare data about race and ethnicity, which is particularly troubling because the Centers for Medicare and Medicaid Services is working, according to the Department of Health and Human Services’ Office of Inspectors. seek to collect such data from providers and payers. Shared.

Medicare enrollment race and ethnicity data is less accurate for some groups, especially for beneficiaries identified as Native American/Alaska, Asian/Pacific Islander or Spain, GREAT Find.

The federal agency claims that this inaccurate data limits its ability to assess health disparities. Limited racial and ethnic categories and missing information contribute to inaccurate enrollment data.

While using an algorithm improves existing data to some extent, it lacks self-reported data, OIG said. And Medicare’s racial and ethnic enrollment data don’t match federal data collection standards, which precludes work to identify and improve health disparities in Medicare communities.


The different impacts of the COVID-19 pandemic on different racial and ethnic groups have brought health disparities to the fore, prompting OIG to conduct research. People of color were found to have disparities in areas such as access and quality of care, which can have significant negative effects on their health.

CMS has made promoting health equity a priority for the Biden Administration, and part of that goal involves ensuring that Medicare can assess disparities – which depends on on the quality of baseline racial and ethnic data.

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

The agency evaluated the accuracy of Medicare enrollment race and ethnicity data for different groups by comparing them with self-reported data for a small group of beneficiaries residing in the United States. nursing home. Self-reported race and ethnicity data are considered the most accurate.

OIG also evaluates the completeness of Medicare data using Federal standards for collecting racial and ethnicity data as a benchmark.


Several recommendations were made in the report. First, the OIG says that CMS should improve its race and ethnicity data – an important work but also an urgent need.

To that end, the OIG has recommended that CMS:

  • develop your own racial and ethnic data sources.
  • use self-reported race and ethnicity information to improve data for existing beneficiaries.
  • develop a process to ensure that data is as normalized as possible.
  • educate beneficiaries about CMS’s efforts to improve information about race and ethnicity.

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

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