Adults and children enrolled in Medical Assistance and MinnesotaCare receive certain cancer screenings, immunization and care for asthma, depression and diabetes less frequently than Minnesotans who have private or employer-based health insurance, according to a report published by MN Community Measurement (MNCM) with the Minnesota Department of Human Services (DHS). A difference between populations, or groups of people, in either access to care or health outcomes indicates that there is disparity.
The 2016 Health Care Disparities Report shows public program enrollees were 19 percent less likely to receive colorectal cancer screening; 16 percent less likely to be screened for breast cancer; 15 percent less likely to receive optimal diabetes care; 12 percent less likely to achieve childhood immunization status and children age 5-17 were 12 percent less likely to receive optimal asthma control when compared to those with private health insurance.
“This report highlights that there is still significant room for improvement to reduce health care disparities,” said Jim Chase, MNCM President.
The 2016 Health Care Disparities Report provides health care performance rates for patients enrolled in Minnesota Health Care Programs (MHCP) including Medical Assistance and MinnesotaCare. Patients enrolled in MHCP represent a population considered at-risk and include a high number of persons of color, American Indians, persons with disabilities and elderly adults. By using MHCP enrollment as a proxy for socioeconomic status, this report evaluates health care disparities that exist as a result of socioeconomic status.
The 2016 Health Care Disparities Report link: https://mncm.org/wp-content/uploads/2017/03/2016-Disparities-Report-Final-2.28.2017.pdf
Improved Health Outcomes
Despite the gaps, Minnesota patients have seen improved health outcomes in most areas measured since the first Health Care Disparities Report was issued ten years ago.
The statewide average for public program enrollees receiving childhood immunization is now 71 percent and has increased 22 percent since first reported in 2007. The statewide average for public program enrollees receiving appropriate testing for pharyngitis, commonly called sore throat, is now 90 percent and has increased 18 percent since first reported in 2007.
Five measures showed statistically significant improvement between 2015 and 2016, including Optimal Asthma Control for Children; Childhood Immunization Status; Colorectal Cancer Screening; Appropriate Testing for Children with Pharyngitis and Appropriate Treatment for Children with Upper Respiratory Infections.
Above Average Medical Groups
All 12 measures in the report are examined at a statewide and medical group level. Medical groups with rates greater than the state average for MHCP patients are noted as above average. For example, Fairview Health Services is listed above average on nine separate measures.
“Fairview is committed to quality health care for all,” said Valerie Overton, DNP, FNP-BC, Vice President Quality and Innovation at Fairview. “We have a two-pronged approach to reducing disparities. The first is to ensure highly reliable processes that deliver quality to every patient with every interaction. The second is to continue our journey to fully understand various populations and individuals. We are using this understanding to customize care approaches when needed to deliver great health care outcomes for all our patients.”
“Both the journey to ensure highly reliable processes and to thoroughly understand our various populations takes time and growth for us as an organization,” added Overton. “MN Community Measurement has been a great partner by bringing clarity on health disparities through this report.”
In 2016, more than 900,000 Minnesotans received health care coverage through Medical Assistance or MinnesotaCare programs overseen by DHS.
Due to the at-risk nature of the MHCP patient population, the Minnesota State Legislature directed DHS in 2005 to establish a performance reporting and quality improvement system for medical groups and clinics providing health care services to patients enrolled in the managed care component of MHCP. The inaugural Health Care Disparities Report was released in 2007, evaluating care provided in 2006, and was the first in the nation to include local level information that was actionable for medical groups and clinics.
This report supplies objective data and brings accountability to medical groups and clinics, allowing them to reflect on their own results and identify areas for improvement within their systems.
“Our mission is to drive substantial health care improvement and reduce gaps in care more quickly for Minnesota’s most vulnerable patients,” said Chase. “Measures help us understand where we are, and where we want to be.”
About Us: 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.