Population characteristics lacking among federal, commercial health plans

Commercial and federal plans still don't have complete data on race, ethnicity and language despite ACA requirements.

Despite a provision within the Affordable Care Act (ACA) that requires health plans to collect patient information on race, ethnicity and language, that data is still missing among federal and commercial payers.

As of 2015, half of Medicaid plans and nearly three-quarters of Medicare plans had complete or partially complete data on race, according to a study published in Health Affairs. Data on ethnicity and spoken language was less prevalent among federal plans, with fewer than half of Medicare and Medicaid plans reporting complete or partially complete data. Similar rates were reported for spoken language data.

Commercial plans fared even worse. Two-thirds of commercial plans did not have any data tied to race and even fewer collected ethnicity or language data, a finding that came as no surprise to study’s authors who noted that commercial payers have few incentives to collect social data.

Researchers with the Centers for Medicare and Medicaid Service (CMS) and the National Committee for Quality Assurance also noted that rates of complete data on race and ethnicity actually declined among Medicare plans. Smaller improvements were found among commercial payers and Medicaid plans.

The researchers noted that standardized data collection efforts and the misconception that members do not want to provide information on race or ethnicity serve as barriers to ongoing data collection efforts. But this data serves as a key element to identifying disparities among certain populations.

“Improving documentation of race, ethnicity, and language needs in managed care plan reporting, regardless of data collection method, and clarifying how high-performing health plans achieve their results, will be important,” the researchers wrote. “The ability to stratify reporting of health quality measures, to target disparities, and to understand effective interventions or strategies for addressing disparities depends on the ability to collect this information consistently.”

RELATED: Report—CMS must collect better data on social determinants of health

The study echoes previous criticisms aimed at CMS for failing to collect data on social risk factors, including race and ethnicity, and also failing to account for social determinants of health.