Reporting CAHPS and HEDIS data by race/ethnicity for Medicare beneficiaries.

OBJECTIVE 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.

[1]  D. Kanouse,et al.  Context-based Strategies for Engaging Consumers with Public Reports about Health Care Providers , 2014, Medical care research and review : MCRR.

[2]  M. Elliott,et al.  How do the experiences of Medicare beneficiary subgroups differ between managed care and original Medicare? , 2011, Health services research.

[3]  M. Elliott,et al.  Using standardized encounters to understand reported racial/ethnic disparities in patient experiences with care. , 2011, Health services research.

[4]  J. Alexander,et al.  A Report Card on Provider Report Cards: Current Status of the Health Care Transparency Movement , 2010, Journal of General Internal Medicine.

[5]  Elizabeth A McGlynn,et al.  Physician cost profiling--reliability and risk of misclassification. , 2010, The New England journal of medicine.

[6]  Katrin Hambarsoomian,et al.  Do Hospitals Rank Differently on HCAHPS for Different Patient Subgroups? , 2010, Medical care research and review : MCRR.

[7]  M. Elliott,et al.  Racial/Ethnic Differences in Patients’ Perceptions of Inpatient Care Using the HCAHPS Survey , 2010, Medical care research and review : MCRR.

[8]  J. Hibbard,et al.  What Is Quality Anyway? Performance Reports That Clearly Communicate to Consumers the Meaning of Quality of Care , 2010, Medical care research and review : MCRR.

[9]  Peter Bower,et al.  Reliability of patient responses in pay for performance schemes: analysis of national General Practitioner Patient Survey data in England , 2009, BMJ : British Medical Journal.

[10]  A. Zaslavsky,et al.  Quality Assessments by Sick and Healthy Beneficiaries in Traditional Medicare and Medicare Managed Care , 2009, Medical care.

[11]  M. Elliott,et al.  Adjusting for subgroup differences in extreme response tendency in ratings of health care: impact on disparity estimates. , 2009, Health services research.

[12]  Y. Hanoch,et al.  Aging and choice: Applications to Medicare Part D , 2009, Judgment and Decision Making.

[13]  Michael E Chernew,et al.  Quality and Consumer Decision Making in the Market for Health Insurance and Health Care Services , 2009, Medical care research and review : MCRR.

[14]  Marije Bosch,et al.  Public Reporting in Health Care: How Do Consumers Use Quality-of-Care Information?: A Systematic Review , 2009, Medical care.

[15]  Robert Weech-Maldonado,et al.  Survey Response Style and Differential Use of CAHPS Rating Scales by Hispanics , 2008, Medical care.

[16]  P. Shekelle,et al.  Systematic Review: The Evidence That Publishing Patient Care Performance Data Improves Quality of Care , 2008, Annals of Internal Medicine.

[17]  A. Zaslavsky,et al.  Relationship between quality of care and racial disparities in Medicare health plans. , 2006, JAMA.

[18]  S. Sofaer,et al.  What do consumers want to know about the quality of care in hospitals? , 2005, Health services research.

[19]  A James O'Malley,et al.  Case-mix adjustment of the CAHPS Hospital Survey. , 2005, Health services research.

[20]  M. Elliott,et al.  Health plan effects on patient assessments of medicaid managed care among racial/ethnic minorities , 2004, Journal of General Internal Medicine.

[21]  N. Lurie,et al.  Variation in racial and ethnic differences in consumer assessments of health care. , 2003, The American journal of managed care.

[22]  M. Elliott,et al.  Race/ethnicity, language, and patients' assessments of care in Medicaid managed care. , 2003, Health services research.

[23]  Judith H Hibbard,et al.  Does publicizing hospital performance stimulate quality improvement efforts? , 2003, Health affairs.

[24]  Donald M. Berwick,et al.  Connections Between Quality Measurement and Improvement , 2003, Medical care.

[25]  M. Elliott,et al.  Differences in CAHPS adult survey reports and ratings by race and ethnicity: an analysis of the National CAHPS benchmarking data 1.0. , 2001, Health services research.

[26]  K. Fiscella,et al.  Inequality in quality: addressing socioeconomic, racial, and ethnic disparities in health care. , 2000, JAMA.

[27]  R. Hays,et al.  Psychometric properties of the CAHPS 1.0 survey measures. Consumer Assessment of Health Plans Study. , 1999, Medical care.

[28]  M. Roizen Physician Cost Profiling — Reliability and Risk of Misclassification , 2011 .

[29]  D. McCaffrey,et al.  Using the Census Bureau’s surname list to improve estimates of race/ethnicity and associated disparities , 2009, Health Services and Outcomes Research Methodology.

[30]  Catherine A. Cole,et al.  Consumer decision making and aging: Current knowledge and future directions , 2009 .

[31]  David Newman,et al.  Testing Consumers' Comprehension of Quality Measures Using Alternative Reporting Formats , 2007, Health care financing review.

[32]  P. Sloane,et al.  Physician-patient communication in the primary care office: a systematic review. , 2002, The Journal of the American Board of Family Practice.

[33]  A. Zaslavsky,et al.  Variation in Patient-Reported Quality Among Health Care Organizations , 2002, Health care financing review.

[34]  A. Zaslavsky,et al.  Adjusting Performance Measures to Ensure Equitable Plan Comparisons , 2001, Health care financing review.