This September 2011 report from the U.S. Department of Health and Human Services describes how data on health care disparities can be identified, collected, and evaluated in the Medicaid program and in the Children’s Health Insurance Program.

Section 4302(a) of the Patient Protection and Affordable Care Act (Affordable Care Act) requires the Secretary of HHS to develop data-collection standards for five demographic categories: race, ethnicity, sex, primary language, and disability status, and calls for data for these categories to be consistently collected and reported in all national population health surveys that rely on self reporting.  Section 4302(b)(1) of the Affordable Care Act requires the collection of data on these five demographic characteristics in Medicaid and CHIP. This section also requires that the collection and reporting of these data in Medicaid and CHIP adhere to the data-collection standards developed under 4302(a). Additionally, Section 4302(b)(2) requires an evaluation of approaches for collecting data in Medicaid and CHIP that allow for the “ongoing, accurate, and timely collection and evaluation of data on disparities in health care services and performance” on these five bases. Section 4302(b)(2) also requires the Secretary to report to Congress on the findings of the evaluation.

This is the report prepared by the Secretary in compliance with Section 4302(b)(2).   In order to implement the approaches outlined in this report and satisfy the additional requirements of Section 4302 of the Affordable Care Act, HHS, in conjunction with the Centers for Medicare & Medicaid Services (CMS), will:

1. Update the Medicaid Statistical Information System (MSIS) to assure reporting of individual demographic information consistent with the standards developed under section 4302(a) of the Affordable Care Act;

2. Work closely with States to support a gradual transition to collecting and reporting into MSIS the new demographic information as part of a larger effort underway to implement provisions of the Affordable Care Act;

3. Revise the Medicare Current Beneficiary Survey to include 4302 standard demographic information;

4. Coordinate work between CMS and the Agency for Healthcare Research and Quality (AHRQ) to revise the Consumer Assessment of Healthcare Providers and Systems survey tools used with Medicaid, CHIP, and Medicare to incorporate the new standards for self-reported demographic information.

Future reports will include recommendations for improving the identification of health care disparities for Medicaid and CHIP enrollees.

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