Research Reports

Resource of Health Equity-related Data Definitions, Standards, & Stratification Practices (PDF)

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This resource can be used as guidance for providers, states, community organizers, and others to improve their health equity-related data collection and analysis. The report includes suggested definitions, standards, and stratification practices for various sociodemographic elements including, race, ethnicity, sex, and others.

Receipt of Buprenorphine and Naltrexone for Opioid Use Disorder in Medicare: Inequities and State Policies that Reduce Gaps (PDF)

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While Medicare enrollees represent a growing number of those with opioid use disorders (OUD), little is known about the diversities in utilization of medications for OUD. This study analyzed associations between sociodemographic characteristics, health-related and policy-related predictors of medications for OUD utilization among Medicare Fee-for-Service enrollees with OUD in 2018.

Impact of Hospital Readmissions Reduction Initiatives on Vulnerable Populations (PDF)

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This study analyzed the roles that key demographic, clinical, and geographic characteristics, as well as hospital quality and type factors, play in hospital readmissions among Medicare enrollees, noting that enrollees of certain demographic, clinical, and geographic backgrounds may have higher risks by social risk factors, and the adverse health consequences associated with those factors, than by their counterparts of other backgrounds.

Opioid Prescription in Medicare Beneficiaries: Prescription Opioid Policies and Implications for Beneficiaries with Sickle Cell Disease (PDF)

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To help inform future policy decisions related to opioid use and their applicability to Medicare enrollees with sickle cell disease (SCD), this report compares opioid utilization patterns among Medicare Fee-for-Service (FFS) enrollees with SCD to two already-exempted populations with complex pain syndromes: non-SCD enrollees with cancer and non-SCD enrollees in hospice care. For context, results for the general FFS population are also provided. Specifically, the report provides a comparison of enrollees in these three populations who use opioids at doses that are equal to or exceed an average daily morphine milligram equivalent (MME) of 120, the MME threshold that aligns with Pharmacy Quality Alliance opioid measures in effect in 2016 during the study’s measurement period, and that defined "high dose opioid use" as daily use exceeding 120 MME.

Putting Patients First: Today's Disparities Research Leading to Health Equity Tomorrow (PDF)

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The Centers for Medicare & Medicaid Services (CMS) has collaborated with a wide variety of stakeholders to support work in all three areas of its path to equity: increasing the understanding and awareness of disparities and their causes, developing and disseminating solutions, and implementing sustainable actions. To increase understanding and awareness of disparities, CMS sponsored this issue, with a goal of contributing to the conversation on health disparities, and emphasizing the value of continuing research in this area. The studies included in this issue underscore the importance of identifying groups of people who do not benefit equally from our health system, and identifying root causes of these differences. We value the information and analysis they provide on this important topic and hope that they will create further discussion on how to reduce health disparities.

Understanding the Health Needs of Hispanic Medicare Beneficiaries (PDF)

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This report provides an enhanced understanding of the health needs of diverse groups of Hispanic Medicare enrollees. Since 2013, the Medicare HOS has been reporting disaggregated results for Hispanic enrollees who self-identify as Cuban, Puerto Rican, Mexican, Other Hispanic, or Multi-ethnic. This report demonstrates that stratifying health data for detailed Hispanic groups reveals unique differences otherwise masked by aggregate analyses, enhancing the ability of public health professionals to identify and monitor the health and health care status of diverse population groups. Data included in the report can be accessed via the link below.

Data Tables [XLSX,85.7KB] - Understanding the Health Needs of Hispanic Medicare Beneficiaries (XLSX)

Toward the Creation of a Patient-Reported Disability Index (PDF)

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This report summarizes the development and initial validation of a Disability Index that reflects the presence and severity of different types of disability measured by the National Health Interview Survey (NHIS). The Disability Index can be used in the future to assess variability in quality of care and access to care along a single dimension of disability.

Understanding the Health Needs of Diverse Groups of Asian and Native Hawaiian or Other Pacific Islander Medicare Beneficiaries (PDF)

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This report provides an enhanced understanding of the health needs of diverse groups of Asian and Native Hawaiians or other Pacific Islanders (NHOPI) enrolled in Medicare. Since 2013, the Medicare Health Outcomes Survey (HOS) has been reporting disaggregated results for distinct Asian and NHOPI groups. Data included in the report can be accessed via the link below.

2017 ANHOPI HOS Baseline Data Tables (XLSX)

Identifying the Transgender Population in the Medicare Program (PDF)

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Despite increased awareness and greater societal acceptance of people who are transgender, the inability to systematically identify and study the transgender population greatly hampers our capacity to conduct meaningful analysis of this group. This paper explores the use of billing data from CMS to identify and describe Medicare’s transgender population.

Develop and Test Sexual and Gender Minority Status (LGBT) Items for the Medicare Beneficiary Survey (PDF)

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Because there has been little work done on sexual and gender identity on the older segments of the population, CMS commissioned NORC to engage in research. A series of cognitive interviews were held, which used existing sexual identity measures to understand the level of comprehension and answerability of these questions among Medicare-eligible individuals. The methodology and results of their work is included in the Develop and Test Sexual and Gender Minority Status Items for the Medicare Beneficiary Survey.

Report to Congress: Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014 Strategic Plan for Accessing Race and Ethnicity Data (PDF)

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This report reviews the literature on the validity of current race and ethnicity data sources in the Medicare program. It outlines potential new options for collecting and using data on the race and ethnicity of people enrolled in Medicare. Some of these options would require new data collection efforts and, in some cases, may require Congressional action. For each option, this report presents information on whether the option would collect data on all or some and current or future enrollees, what race and ethnicity categories would be used, whether new data collection is required, and also notes any limitations and anticipated barriers to collecting or accessing the data.

Analysis of Participation in the Medicare Electronic Health Records Incentive Program (PDF)

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Since January 2011, thousands of eligible providers, eligible hospitals, and critical access hospitals have participated in the the Medicare Promoting Interoperability Program, formerly known as the Medicare Electronic Health Records (EHR) Program. Many eligible for this program have yet to register or attest to Stage 1 Meaningful Use. If some providers are left behind, this may create a gap in quality, cost, and efficiency between those who have adopted and meaningfully use EHRs and those who have not. The factors influencing program participation, however, are not fully clear. The research report provides information about the population studied, research objectives, principal findings, and conclusion.

Executive Summary: Analysis of Participation in the Medicare EHR Incentive Program (PDF)

Report of Findings: Analysis of Participation in the Medicare EHR Incentive Program (PDF)

Develop & Test Limited English Proficiency Items for the Medicare Beneficiary Survey (PDF)

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To better serve Medicare enrollees with limited English proficiency (LEP), CMS commissioned NORC at the University of Chicago to conduct a literature review of existing metrics for measuring LEP and evaluations of their effectiveness. The research report presents main findings as well as recommendations for a set of LEP items to be included in the Medicare Beneficiary Survey.