This paper discusses concrete steps that the Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS) could take today within the scope of their current legislative authority to address racial and ethnic disparities in Medicare. The first and most important of these steps is for HHS and CMS to make the elimination of racial and ethnic disparities from the Medicare program a top priority. If the disparity problem were to become a priority for Medicare—as important, for example, as the promotion of the Medicare Advantage or the new prescription drug program is currently to CMS–much could be accomplished. Once CMS and HHS decide that addressing racial and ethnic disparities is an issue worthy of greater attention, there are many steps that they can potentially take to deal with disparities. The paper identifies four causes of racial and ethnic disparities—financial barriers to access, institutional barriers to access, professional attitudes and behavior, and beneficiary attitudes and behavior—and discusses what HHS and CMS can do to address each cause.
This paper was commissioned by the NASI Study Panel on Medicare and Racial and Ethnic Disparities.