I spent the whole of Ma Rainey's thinking "this would make an excellent play", which it turns out is pretty accurate, given that the film is an adaptation of the stage show. In some ways, I think it would work better on stage; there are elements that don't translate that well to the screen. A clear example of the piano-based monologue/cutaway halfway through with one of the musicians. On stage, it would be made clear that this is a flashback/character moment through lighting and positioning, but it just felt disjointed and a bit out of place in a film context. Dialogue also feels more like monologues mixed in with exposition than natural language, which again would work well on stage but comes across as a little stilted in this setup.
That said, the character work is excellent, and if you accept that this is more stage performance than biography, the plot flows incredibly well, masterfully building tension to a climax that was as surprising as it was depressing. Casting is equally excellent, though in particular (of course) Viola Davis as Ma and Chadwick Boseman as her upstart horn player knock it out of the park. But most importantly, the script has a real weight to it that delivers a perfectly formed and unfortunately timely message about race, culture, history, and persecution. It's a damning message, with the main spotlight shone on the oppressive undertones of modern culture and the long shadow cast by slavery and systemic racism, but it isn't afraid to also take aim at elements of Black (American) culture as well. That combination provides a nuance often lacking and adds extra impact to the finale that elevates the whole considerably.
The result is a brilliantly performed and directed film with a real sense of self, time, and message which sets it apart. It wasn't quite what I was expecting, and the format took some getting used to, but if you go in with that understanding I think most would be hard-pressed not to applaud the outcome.