Evaluating race and Hispanic origin responses of Medicaid participants using census data

Abstract

Monitoring and addressing racial and ethnic disparities in health and health care require the collection and analysis of reliable demographic information. With the intention of improving the measurement and monitoring of disparities, certain provisions of the Patient Protection and Affordable Care Act (ACA) of 2010 require states to collect, report, and analyze data on demographic characteristics of applicants and participants in Medicaid and other federally supported programs. In this large-scale study we link Medicaid records to the Census 2000, the 2010 Census, and the American Community Survey for years 2001–2009 to explore the extent to which pre-ACA Medicaid administrative records matched self-reported race and Hispanic origin in Census Bureau data. Record linkage allows comparison of demographic, socioeconomic and neighborhood characteristics between Medicaid participants with matching and non-matching race and Hispanic origin in census. Identification of the groups most likely to have non-matching and missing race and Hispanic origin data in Medicaid relative to census can inform strategies to improve the quality of demographic data collected from the Medicaid population.