Insurers Take a Comprehensive Approach to Collecting Data on Race and Ethnicity

According to Caroline Pearson, senior vice president of the non-partisan research organization NORC at the University of Chicago, Medicare and Medicaid plans have the most complete data on race and ethnicity, while employer-based or individual plans lag the farthest.

Marketplace plans tend to fall somewhere in between: During the 2022 open enrollment period for federal marketplace plans, race or ethnicity data was collected for about 70% of participants, according to researchers at the Center for Health Insurance Reform at Georgetown University. In government markets, race or ethnicity was listed for approximately 77% of participants.

Interest rates may increase soon as the federal government rolls out programs to incorporate equity data into quality measures.

The Centers for Medicare and Medicaid Services will begin requiring marketplace issuers and Medicare Advantage plan issuers to provide member race and ethnicity data in January 2023. such as colorectal cancer screening, high blood pressure treatment, and prenatal care.

Some accreditation bodies also add enhanced data collection standards to their insurer requirements, such as Medicaid insurers, exchange programs, and employer plans in some states.

In anticipation, insurers have launched mail, website, and mobile app surveys to collect racial, ethnic, and other information about their members. They turn to data brokers and employers for help, and direct customer success professionals and call centers to ask for identity during customer interactions.

But there are kinks in every strategy that require insurers to take a holistic approach, Reynolds said.

Polls can have selection bias. A member may not fit into any of the provided categories, or may wish to provide information at all, making the data incomplete.

The definition of race and ethnicity may vary between brokers, health plans, and other entities, making it difficult to validate and combine datasets. Adding optional questions about race and ethnicity to an employer’s health insurance registration forms requires an additional layer of communication between insurers and employers.

And in cases where an insurance representative is involved, the worker may assume the member’s race by their appearance or the sound of their voice, which can lead to inaccuracies.

“What is missing right now is the lack of a systematic or standardized collection,” Reynolds said.

Federal agencies are giving insurers certain guidelines when it comes to sorting data. In 1997, the OMB established broad demographic categories for federal reporting; in June, agency officials announced a revision of the standards expected to be completed by 2024. The standards include five broad categories of race: American Indian/Alaska Native, Asian, Black/African American, Native Hawaiian/Other Pacific Islander, and White. — and one category, Hispanic/Latino, for ethnicity.