Race and Ethnicity, Neighborhood Social Deprivation and Medicare Home Health Agency Quality for Persons Living With Serious Illness.

The study used agency star ratings, not patient outcomes, so it cannot tell whether a patient received better clinical care. It included only beneficiaries who accessed home health care, so it cannot describe people who needed home health care but did not receive it. Race and ethnicity were grouped as recorded in the home health assessment, which may not capture diverse identities. Medicaid enrollment was taken from the assessment and may be inaccurate. The star rating combines several outcome and process measures and can be unstable over time, so it is a coarse measure of quality. The analysis is observational, so it cannot identify the mechanisms that create disparities.

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication.

Do not read these associations as evidence that a patient's race or Medicaid status caused lower quality care. The study linked patients to agency star ratings and could not measure the resources, staffing, referral patterns, or care processes inside each agency.