Imputation of Race/Ethnicity to Enable Measurement of HEDIS Performance by Race/Ethnicity

Published in: Health Services Research, Volume 54, Issue 1, pages 13–23 (February 2019). doi: 10.1111/1475-6773.13099

Posted on RAND.org on September 17, 2021

by Ann C. Haas, Marc N. Elliott, Jake Dembosky, John L. Adams, Shondelle Wilson-Frederick, Joshua Mallett, Sarah J. Gaillot, Samuel C. Haffer, Amelia Haviland

Read More

Access further information on this document at Health Services Research

This article was published outside of RAND. The full text of the article can be found at the link above.

Objective

To improve an existing method, Medicare Bayesian Improved Surname Geocoding (MBISG) 1.0 that augments the Centers for Medicare & Medicaid Services' (CMS) administrative measure of race/ethnicity with surname and geographic data to estimate race/ethnicity.

Data Sources/Study Setting

Data from 284,627 respondents to the 2014 Medicare CAHPS survey.

Study Design

We compared performance (cross-validated Pearson correlation of estimates and self-reported race/ethnicity) for several alternative models predicting self-reported race/ethnicity in cross-sectional observational data to assess accuracy of estimates, resulting in MBISG 2.0. MBISG 2.0 adds to MBISG 1.0 first name, demographic, and coverage predictors of race/ethnicity and uses a more flexible data aggregation framework.

Data Collection/Extraction Methods

We linked survey-reported race/ethnicity to CMS administrative and US census data.

Principal Findings

MBISG 2.0 removed 25–39 percent of the remaining MBISG 1.0 error for Hispanics, Whites, and Asian/Pacific Islanders (API), and 9 percent for Blacks, resulting in correlations of 0.88 to 0.95 with self-reported race/ethnicity for these groups.

Conclusions

MBISG 2.0 represents a substantial improvement over MBISG 1.0 and the use of CMS administrative data on race/ethnicity alone. MBISG 2.0 is used in CMS' public reporting of Medicare Advantage contract HEDIS measures stratified by race/ethnicity for Hispanics, Whites, API, and Blacks.

Research conducted by

This report is part of the RAND Corporation External publication series. Many RAND studies are published in peer-reviewed scholarly journals, as chapters in commercial books, or as documents published by other organizations.

Our mission to help improve policy and decisionmaking through research and analysis is enabled through our core values of quality and objectivity and our unwavering commitment to the highest level of integrity and ethical behavior. To help ensure our research and analysis are rigorous, objective, and nonpartisan, we subject our research publications to a robust and exacting quality-assurance process; avoid both the appearance and reality of financial and other conflicts of interest through staff training, project screening, and a policy of mandatory disclosure; and pursue transparency in our research engagements through our commitment to the open publication of our research findings and recommendations, disclosure of the source of funding of published research, and policies to ensure intellectual independence. For more information, visit www.rand.org/about/principles.

The RAND Corporation is a nonprofit institution that helps improve policy and decisionmaking through research and analysis. RAND's publications do not necessarily reflect the opinions of its research clients and sponsors.