CMS uses data to tackle disparities in care

Agency to work with insurers to close quality gaps in Medicare Advantage.


A data analytics project done at the Centers for Medicare and Medicaid Services has the agency acknowledging that the Medicare Advantage managed care program suffers from racial and ethnic disparities in care.

According to a report from CMS, African Americans and Hispanic beneficiaries had significantly more difficulty receiving needed care and making medical appointments than Whites, and African Americans had a tougher time getting prescriptions than Whites.

“While these data do not tell us why differences exist, they show where we have problems and can help spur efforts to understand what can be done to reduce or eliminate differences,” Cara James, PhD, director of the CMS Office of Minority Health, said in a statement.

The data comes from the Healthcare Effectiveness Data and Information Set of medical and administrative data on how well the needs of Medicare beneficiaries are being met, as well as the Medicare Consumer Assessment of Healthcare Providers and Systems.

Measures reported include patient experiences of the ease of getting care and information about their drug coverage and costs, and clinical care measures such as appropriate disease screenings and whether beneficiaries’ medical conditions are being adequately controlled. In total, there are eight patient experience measures and 27 clinical care measures.

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The report compares these measures for African American, American Indian/Alaska Native, Asian or Pacific Island, and Hispanic beneficiaries against measures for Whites. In measuring patient experience getting needed care, the data shows American Indian/Alaska Native only slightly had less difficulty than Whites, but other ethnicities had considerably more difficulty.

American Indian/Alaska Native beneficiaries also had easier experiences with getting appointments and care quickly—even outpacing Whites—as well as reporting easier access to health plan information.

Based on a scoring range of 0 to 100, all ethnicities except Asian/Pacific Island had better scores than Whites on how well doctors communicated with patients. Scores for how well care was coordinated ranged from 81.0 for Asian/Pacific Islander to 87.4 for American Indian/Alaska Native. Asian/Pacific Islander beneficiaries also lagged other groups in getting needed prescription drugs.

The report is available here.

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