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Understanding Health Care Reform and MassHealth Communities of Color. The Massachusetts Health Disparities Council Tom Dehner, Medicaid Director April 27, 2009. Overview. Current MassHealth race & ethnicity data Impact of HCR Efforts to increase race and ethnicity data collection
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Understanding Health Care Reform and MassHealth Communities of Color The Massachusetts Health Disparities Council Tom Dehner, Medicaid Director April 27, 2009
Overview • Current MassHealth race & ethnicity data • Impact of HCR • Efforts to increase race and ethnicity data collection • Acute hospital pay for performance measures on disparities • Next Steps
Race and Ethnicity Data Details • Data is primarily self-reported on application for coverage. • Data source is the MassHealth data warehouse. • “Other” Race/Ethnicity category adds Other, Native American, Alaskan American, and Asian/Pacific Islander together. • The “MassHealth and Health Reform Programs” includes enrollment in MassHealth, CommCare and the Health Safety Net.
Changes Over Time • From FY2004, before Health Reform, to FY 2008 for MassHealth enrollment only: • The “Other” category grew the most, led by 83% increase of Asian Americans. • Hispanic grew 47% • Black grew 40% • White grew 18% • From FY2004 to present, for all Health Care Reform programs, there has been significant growth in the “not answer” segment.
Efforts to Increase Race & Ethnicity Data Reporting • Systematic edits in the application process are being made to ensure that new members or members re-determining eligibility are reminded to provide race and ethnicity data. • MassHealth is working with the Common Client Index Project to develop strategies for race and ethnicity data sharing across EOHHS agencies that serve MassHealth members. • Strategies to work with the provider community to increase race and ethnicity data collection are being considered.
Acute Hospital P4P Health Disparities Measurement • Structural measures account for organizational factors that affect healthcare disparities. • Clinical measures assess disparities by clinical quality indicators. • Disparities measures data collection began RY08.
Health Disparities Measure Development Process • Conduct Environmental Scan • Review National/State Health Disparities Initiatives • Review medical literature on factors contributing to disparities • Review literature on system factors and approaches to reducing disparities (IOM, JCAHO, CMS, NCQA, NQF, Baldridge) • Review literature on cultural competence/CLAS measures to identify consensus on measure constructs and quality scoring models (Baldridge, NCQA, Medicare) • Consult with Stakeholder Industry Leaders • AHRQ Office Clinical Quality (Nat’l Health Disparities Report Methods) • Federal DHHS Office Minority Health • National Quality Forum – Cultural Competence Measures Project • Boston Public Health Commission Hospital Disparities Workgroup • MA Medicaid Policy Institute Disparities Roundtable • MA Commercial Payer Initiatives: BCBSMA, HPHC, Tufts, GIC • MassHealth Hospital Quality Advisory Committee (HQAC)
Next Steps • Improved reporting of race and ethnicity data is essential. • MassHealth is committed to increasing the work with our provider and member communities to improve access and delivery of quality care. • Disparities measured by claims data versus survey data create different challenges.
