OIG says Medicare race data is inaccurate and hampers estimates of health differences

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There are significant inaccuracies in Medicare’s data on race and ethnicity, which is particularly worrying given that Medicare and Medicaid service centers seek to collect such data from providers and payers, according to the Department of Health and Human Services inspector’s office. social services

Medicare’s race and ethnicity data are less accurate for some groups, especially for beneficiaries identified as Native Americans / Alaska Natives, Asian / Pacific Islanders or Hispanics, OIG found.

These inaccurate data, according to the federal agency, limit the ability to assess health differences. Restricted racial and ethnic categories and missing information contribute to inaccuracies in the recording data.

Although the use of an algorithm improves existing data to some extent, it does not match the self-reported data, OIG said. And Medicare’s record of race and ethnicity is incompatible with federal data collection standards, which hampers work to identify and improve health disparities in the Medicare population.


The different effects of the COVID-19 pandemic on different racial and ethnic groups have brought health differences to the forefront, prompting the OIG to conduct the study. It has been found that colored people experience differences in areas such as access to and quality of care, which can have significant negative consequences for their health.

CMS has made the promotion of health equity a top priority for the Biden administration, and part of that goal includes ensuring that Medicare is able to assess differences – depending on the quality of basic race and ethnicity data.

The OIG analyzes the race and ethnicity data in the Medicare enrollment database, the only source of information on enrolled beneficiaries. These data, in turn, are derived from the 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 race and ethnicity data for different groups by comparing it with self-reported data for a subgroup of beneficiaries residing in nursing homes. Self-reported data on race and ethnicity are considered the most accurate.

The OIG also assessed the adequacy of Medicare data, using federal standards to collect race and ethnicity data as a benchmark.


The report made several recommendations. On the one hand, the OIG said that the CMS needs to improve its data on race and ethnicity – a significant undertaking, but also an urgent need.

To this end, the OIG recommended the CMS:

  • develop your own source of data on race and ethnicity.
  • use self-reported race and ethnicity information to improve data on current beneficiaries.
  • develop a process to ensure that data is as standardized as possible.
  • to educate beneficiaries about the CMS’s efforts to improve information on race and ethnicity.

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

Twitter: @JELagasse
Email the writer: jeff.lagasse@himssmedia.com

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