Reporting CAHPS and HEDIS Data by Race/Ethnicity for Medicare Beneficiaries

Published in: HSR, Health Services Research, v. 48, no. 2, part 1, Apr. 2013, p. 417-434

Posted on RAND.org on January 01, 2012

by Steven Martino, Robin M. Weinick, David E. Kanouse, Julie A. Brown, Amelia Haviland, Elizabeth Goldstein, John L. Adams, Katrin Hambarsoomian, David J. Klein, Marc N. Elliott

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Research Question

  1. Can racial/ethnic group-specific quality of care data be reliably compiled and meaningfully reported to Medicare beneficiaries?

To produce reliable and informative health plan performance data by race/ethnicity for the Medicare beneficiary population and to consider appropriate presentation strategies. DATA SOURCES: Patient experience data from the 2008-2009 Medicare Advantage (MA) and fee-for-service (FFS) CAHPS surveys and 2008–2009 HEDIS data (MA beneficiaries only). STUDY DESIGN: Mixed effects linear (and binomial) regression models estimated the reliability and statistical informativeness of CAHPS (HEDIS) measures. PRINCIPAL FINDINGS: Seven CAHPS and seven HEDIS measures were reliable and informative for four racial/ethnic subgroups--Whites, Blacks, Hispanics, and Asian/Pacific Islanders--at sample sizes of 100 beneficiaries (200 for prescription drug plans). Although many plans lacked adequate sample size for reporting group-specific data, reportable plans contained a large majority of beneficiaries from each of the four racial/ethnic groups. CONCLUSIONS: Statistically reliable and valid information on health plan performance can be reported by race/ethnicity. Many beneficiaries may have difficulty understanding such reports, however, even with careful guidance. Thus, it is recommended that health plan performance data by subgroups be reported as supplemental data and only for plans meeting sample size requirements.

Key Finding

  • Statistically reliable and valid information on health plan performance can be reported by race/ethnicity, but many beneficiaries may have difficulty understanding such reports.

Recommendation

  • Data by race/ethnicity should be reported as supplemental data, and only for plans meeting sample size requirements.

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