Over four decades, racial and ethnic gaps in the utilization of health care services and quality of care provided to Medicare beneficiaries have been reduced but not eliminated. This paper provides an inventory of programs and initiatives implemented by the Centers for Medicare & Medicaid Services to reduce remaining disparities in the Medicare program. These include efforts to: (1) develop culturally appropriate education and outreach; (2) measure and reduce clinical health care disparities through beneficiary and provider-focused interventions; and (3) enhance providers’ cultural competency. The paper describes the initiatives, the disparities they seek to reduce, efforts to evaluate them, and their actual and potential impact to reduce disparities. The central finding is that, despite successes in some areas, ongoing efforts have had limited reach and limited impact on racial disparities. The paper identifies ways to enhance these ongoing efforts and considerations for the development of future initiatives.
This paper was commissioned by the NASI Study Panel on Medicare and Racial and Ethnic Disparities.