Background: Effective patient-provider communication regarding treatment options and shared decision-making are crucial for building trust in healthcare. Patient-provider racial/ethnic concordance may play a vital role in facilitating this, particularly during the COVID-19 pandemic, which disrupted healthcare continuity and increased reliance on telehealth. This study aimed to evaluate the relationships between patient-provider racial/ethnic concordance, shared decision-making, and communication in 2020.

Methods: A sample of 9,634 adults from the 2020 U.S. Medical Expenditure Panel Survey was analyzed. Shared decision-making and communication were assessed based on patient inclusion in decision-making and provider explanation of treatments. Complex sampling logistic regression modeling was used to evaluate associations. Control variables included poverty, age, marital status, education, insurance, and race/ethnicity.

Results: Approximately two-thirds of the sample (66%; CI_95%: [64.27–67.43]) was seen by a racial/ethnic concordant provider. Adjusting for controls, concordance was strongly associated with provider communication of treatment options (OR_{[Concordant vs. Discordant]}=1.50; CI_95%: [1.15–2.13]). Patient inclusion in decision-making was associated only with patient race/ethnicity (OR_{[NH White vs. All others]}=1.41; CI_95%: [1.21–1.65]) and marital status (OR_{[Married vs. Not married]}=1.15; CI_95%: [1.04–1.28]).

Discussion: Providers were more likely to explain treatment options to patients of their same race/ethnicity, and shared decision-making was more common among Non-Hispanic White patients, regardless of provider race. Policymakers and public health officials should consider these findings when addressing disparities in access and outcomes among underserved populations. Further research is needed to understand the mechanisms behind these associations and the potential changes in the role of concordance in decision-making during the pandemic.