CMS Releases Medicare Advantage Quality Data for Racial and Ethnic Minorities

WASHINGTON, D.C. (April 20, 2016)—The Centers for Medicare & Medicaid Services (CMS) Office of Minority Health released data detailing the quality of care received by people with Medicare Advantage by racial or ethnic group.

“This is the first time that CMS has released Medicare Advantage data stratified by race and ethnicity. Increasing understanding and awareness of disparities and their causes is the first step of our path to equity,” said Dr. Cara James, director of the CMS Office of Minority Health. “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 these differences.”

The data are based on an analysis of two sources of information. The first is part of the Healthcare Effectiveness Data and Information Set (HEDIS). HEDIS collects information from medical records and administrative data on how well the needs of Medicare beneficiaries are met for a variety of medical issues, including diabetes, cardiovascular disease, and chronic lung disease. The second part is the Medicare Consumer Assessment of Healthcare Providers and Systems (CAHPS) Survey, which is conducted annually by CMS. CAHPS focuses on the health care experiences of Medicare beneficiaries across the nation.

The database presents HEDIS and CAHPS scores for different racial and ethnic groups at the level of individual Medicare contracts and is intended to be used to improve quality and accountability. The information provided by this database is not used to evaluate care through the star ratings program Medicare Advantage and Part D Star Ratings program nor is not it used for payment purposes.

“These data are a good first step in understanding disparities in Medicare Advantage,” said Sean Cavanaugh, CMS deputy administrator and director of the Center for Medicare. “We look forward to working with plans in closing the differences in the quality of care that people with Medicare Advantage receive.”

A report summarizing the data accompanied the release. Analysis of the quality of care delivered to beneficiaries showed that Asians and Pacific Islanders typically received care that is similar to or better than the care received by whites, whereas African Americans and Hispanics typically received care that is similar to or worse than the care received by whites. African Americans and Hispanics also reported their health care experiences as being similar to or worse than the experiences reported by whites. This data help to highlight the racial and ethnic disparities that occur within health care.

The data and summary report can be viewed here.