Quality of Care Health Disparities

As part of the overarching Centers for Medicare & Medicaid Services (CMS) initiative to support health care quality improvement to underserved Medicare and Medicaid enrollees, CMS is engaged in a multi-partner health disparities collaboration. This unique collaboration includes:

  • Iintra-agency partners
  • Private and public sector stakeholders
  • State partners
  • Community-based organizations
  • Underserved communities
  • Other stakeholders.

Results of this collaboration to date include the addition of a health disparities component into the CMS quality initiatives while also providing enrollees with information about CMS programs.

Center for Medicaid and CHIP Services Objectives

  • Disseminate information about promising practices in health disparities in Medicaid and CHIP to the forum and external organizations.
  • Identify vulnerabilities and areas of opportunity in Medicaid and CHIP for quality improvement and the reduction of health disparities in Medicaid enrollees.
  • Identify and collaborate with states and external organizations to develop partnerships to reduce health disparities in Medicaid and CHIP.

Health Disparities Data Collection in Medicaid and CHIP

The Affordable Care Act of 2010 (Section 4302) requires the secretary of the Department of Health ad Human Services (HHS) to establish data collection standards for race, ethnicity, sex, primary language, and disability status, and calls for these categories to be consistently collected and reported in all national population health surveys that rely on self-report.  Section 4302(b)(1) requires the collection of data on these five demographic characteristics in Medicaid and CHIP, and requires that the collection of these data in Medicaid and CHIP adhere to the data-collection standards developed in 4302(a). 

Section 4302(b) required a report to Congress on approaches for identifying, collecting, and evaluating data on health care disparities on the basis of race, ethnicity, sex, primary language, and disability status in Medicaid and CHIP.  This report includes information on the evaluation conducted by HHS, reviews federal policies guiding the collection of data on these five demographic categories, and identifies what data are currently collected in each state and by CMS on these five bases. The report also makes recommendations on next steps needed to implement the approaches identified in this report. A 2014 report to Congress details the progress HHS has made in implementing approaches for identifying, collecting, and evaluating data on health care disparities in Medicaid and CHIP, including recommendations for improvement.

Health Care Coverage Analyses of the National Healthcare Quality and Disparities Reports

In 2008, the Agency for Healthcare Research and Quality (AHRQ) produced for CMS, “Health Care Coverage Analyses of the 2006 National Healthcare Quality and Disparities Reports,”  which examined disparities by insurance status (private, Medicaid, and uninsured) and race/ethnicity for the non-elderly population.  An update to this report, “Health Care Coverage Analyses of the National Healthcare Quality and Disparities Reports: 2000-2008 Trends,” observes how quality and access has changed for individuals with private insurance, Medicaid, and no insurance over time, and examines racial and ethnic disparities within insurance groups.

HHS Action Plan to Reduce Racial and Ethnic Disparities

HHS unveiled its Action Plan to Reduce Racial and Ethnic Health Disparities ("HHS Disparities Action Plan") in April 2011, which outlines goals and actions HHS will take to reduce health disparities among racial and ethnic minorities.

CMS is the lead agency for a number of actions in the HHS Disparities Action Plan, including efforts to increase access to dental care for children in Medicaid and CHIP, and improve language access in Medicaid and CHIP. 

National Stakeholder Strategy for Achieving Health Equity

The HHS Action Plan to Reduce Racial and Ethnic Health Disparities complements the National Stakeholder Strategy for achieving health equity ("NPA Stakeholder Strategy"), which proposes a comprehensive, community-driven approach to reduce health disparities in the U.S. and achieve health equity through collaboration. Together, the HHS Disparities Action Plan and the NPA Stakeholder Strategy provide strong and visible national direction for leadership among public and private partners.