February 10, 2016 – It’s well known that significant disparities exist in health care outcomes in Minnesota; however, first time analysis indicates significant disparities exist across patient experiences of care as well, according to the 2015 Health Equity of Care Report.
The second-year report, which was released today by MN Community Measurement (MNCM), deepens our understanding of health care disparities in Minnesota with the addition of two major features: four patient experience measures segmented by race and Hispanic ethnicity; and comparable medical group reporting of the five quality measures included in last year’s report.
The report’s major findings include:
- Significant inequities in health care outcomes based on race, Hispanic ethnicity, preferred language and country of origin persist throughout Minnesota.
- Disparities are particularly distinct among patients who are American Indian or Alaskan Native; Black or African American; Hispanic; and/or were born in or prefer to speak the native languages of Laos, Somalia and Mexico.
- Generally, racial and ethnic groups with better health outcomes rated their care experiences better as well. However, Asian patients generally had high quality outcomes but rated their experiences of care the lowest of any racial group.
- Patients in Greater Minnesota overall had poorer health care outcomes than Metro-area patients.
- Large, Metro-area medical groups tended to have higher quality outcomes across the majority of race, Hispanic ethnicity, preferred language and country of origin patient categories than medical groups in Greater Minnesota or of smaller size.
“Successfully addressing health inequities on a large scale requires consistent, actionable data that offers a window into the disparities,” said Jim Chase, MNCM President. “This report shows there are places in our community that are achieving better health care outcomes for all patients and we need to learn from providers who are having success.”
The Health Equity of Care Report offers a glimpse into disparities experienced by communities of color, immigrant communities and rural residents of Minnesota. It contains information collected from patients seen for appointments at medical groups throughout Minnesota, and evaluates health care quality in five areas and patient experience of care in four areas.
The results for five health care quality measures were segmented by race, Hispanic ethnicity, preferred language and country of origin. These are reported at statewide, regional and medical group levels. The measures are: Colorectal Cancer Screening; Optimal Asthma Control – Adults; Optimal Asthma Control – Children; Optimal Diabetes Care; and Optimal Vascular Care.
The results of four Patient Experience of Care domains were segmented by race and Hispanic ethnicity, and are reported at statewide and regional levels. The domains are: Access to Care; Helpful and Courteous Staff; Provider Communication; and Provider Rating.
“This information helps identify what health care disparities exist in Minnesota,” Chase said, “however; it does not explain why they exist, which is why sharing it with our community is critical to truly addressing inequities.”
For the first time, the Health Equity of Care Report includes clinical quality measure results segmented by race, Hispanic ethnicity, preferred language and country of origin reported by medical group.
Allina Health Clinics and Allina Specialties; HealthPartners Clinics; Park Nicollet Health Services; and Fairview Health Services generally had the highest rates across multiple quality measures and patient populations.
Reporting this information at the medical group level is a significant milestone because it brings the results to the level where accountability for patient outcomes lies in the health care system. Provider groups compare themselves to their peers and then evaluate the barriers faced by specific patient populations when seeking care at their practice. The report contains perspectives on health equity from six different organizations on how they are using this information to get better outcomes for patients.
We caution against jumping to conclusions about specific medical groups based on the information in this report. Rather, we encourage its use by medical groups and community organizations to work collectively to address the disparities that are identified.
Other report findings include:
- White and Asian patients generally had the highest rates of optimal care, while American Indian or Alaskan Native and Black or African American patients generally had the lowest rates. This is consistent with the findings of our 2014 report.
- Hispanics tended to have lower health care outcomes than non-Hispanics; however, this was not consistent across all regions. In particular, Hispanic patients had higher rates than non-Hispanics in some regions for Optimal Vascular Care and Optimal Asthma Control – Children.
- Patients born in Laos, Somalia and Mexico and/or who preferred speaking Hmong, Somali and Spanish generally had the poorest health outcomes compared to other country of origin and preferred language groups.
- Rates varied considerably across geographic areas of Minnesota. The East Metro region generally had higher rates across multiple measures and multiple patient populations than other regions. The Northwest and Southwest regions tended to have the lowest rates across measures and patient groups.
- Patients in Greater Minnesota overall had poorer health outcomes than patients in the 13-county Metro area; in particular, White patients in Greater Minnesota had lower rates than many other racial groups.
- The Southeast region generally had the highest Patient Experience of Care rates, while the Northwest region generally had the lowest.
MNCM released The Handbook on the Collection of Race/Ethnicity/Language Data in Medical Groups in 2008. This defined and standardized the information that should be collected from patients by clinics and medical groups, as well as set best practices for collection and reporting. Since then, Minnesota providers have steadily improved their collection and reporting of race, ethnicity, language and country of origin data.
In 2015, nearly all Minnesota providers submitted REL data to MNCM and three-quarters did so using best practices. Most providers that have not passed MNCM’s best practices audit are already collecting data from patients using best practices and are taking steps to address technical hurdles related to capturing and reporting the data in their electronic health records. Only data from medical groups who have successfully demonstrated to MNCM that they follow these best practices is included in the Health Equity of Care Report.
This report is unique because medical groups across the state collect and report the data in a standardized format, which allows MNCM to compare results across medical groups and regions.
“Our health care community is to be commended for its dogged pursuit of and support for the standard collection and reporting of REL data. We collect more data on health disparities than any other state, allowing us to target inequities more effectively,” Chase said.
MN Community Measurement is a non-profit organization dedicated to improving health by publicly reporting health care information. A trusted source of health care data and public reporting on quality, cost and patient experience since 2003, MNCM works with medical groups, health plans, employers, consumers and state agencies to spur quality improvement, reduce health care costs and maximize value. Learn more at MNCM.org.