Case study: Reducing disparities in healthcare outcomes | KPMG | US

Case study: Reducing disparities in healthcare outcomes

Case study: Reducing disparities in healthcare outcomes


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Principal, Advisory Services, Federal Healthcare at KPMG

KPMG in the U.S.


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The Challenge

The Centers for Medicare & Medicaid Services (CMS) Office of Minority Health (OMH) is tasked with ensuring that the interests and needs of minority populations are represented and accounted for in programs and policies developed, implemented, and evaluated by CMS. Developing and implementing programs in a way that reduces, and eventually eliminates, disparities in healthcare quality, access, and outcomes that exist between minority populations is crucial to OMH’s success. CMS OMH strives to better leverage the available data to achieve these goals.

KPMG's Response

CMS OMH engaged KPMG, through the National Opinion Research Center (NORC) at the University of Chicago, to provide data analytic support by documenting disparities that exist between different racial and ethnic groups of Medicare beneficiaries with chronic conditions. Our key activities are documented below:

  • Measure development: Develop measures that provide descriptive statistics on health outcomes and quality of care for Medicare beneficiaries across different populations defined by gender, age groups, dual eligibility status, racial and ethnic groups, and geography. These measures include prevalence rates, total and principal costs of care, hospitalization rates, prevention quality indicators (PQIs), 30-day all-cause mortality rates, and 30-day unplanned readmission rates.
  • Trending analytics: Track the health of the populations by analyzing how the above measures change over time using multiple years of data. 
  • Interactive visualization tool: Develop a tool that will allow the CMS and general public to easily navigate and understand the vast amount of information in a user-friendly way.

The Result

While the project is ongoing, KPMG has achieved significant results for CMS OMH.                                                                                        

To date, KPMG has created a heat map of the United States, using CMS Medicare claims and enrollment data, which offers users a customizable query based on a chosen condition and measure, by gender, age, dual eligibility status, and racial and ethnic group. The tool presents the measures by state or county and distinguishing urban and rural counties. It also provides built-in calculations that allow users to analyze disparities between any two racial and ethnic groups within a geography as well as between geographies for a specific racial and ethnic group. The users can easily identify where the largest disparities exist between any two racial and ethnic groups, or how the measures for a racial and ethnic group in a county compares to the county, state, or national average. With the insights provided by the tool, more targeted population health interventions are possible, potentially improving health outcomes and reducing the disparities identified.

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