Field of Work: Using a collaborative to reduce disparities in diabetes treatment.
Problem Synopsis: Members of racial and ethnic minority groups are less likely than Whites to receive needed health care and often receive care of lower quality, according to the Institute of Medicine (IOM). The IOM called on health insurance companies, which have significant potential to address health care disparities because they have access to clinical and administrative information systems to track enrollees over time, to collect patient care data to build a foundation to solve the problem. Health plans also have a financial incentive to improve quality. In late 2003, several major health insurers approached the U.S. Department of Health and Human Services' Agency for Healthcare Research and Quality (AHRQ) about forming a collaborative to address racial and ethnic disparities in health care.
Synopsis of the Work: From September 2004 to September 2008, the Center for Health Care Strategies led the National Health Plan Collaborative, a group of 11 national health insurance plans, in a project to reduce disparities in health care, focusing primarily on treatment for diabetes.
- Health plans in the collaborative collected race and ethnicity data on their members, linked the information to their data on diabetes care and then conducted an analysis to determine if there were racial or ethnic disparities in care.
- Collaborative members designed and tested pilot projects to reduce disparities in health care for minorities at the provider, member and community levels.
Key Evaluation Findings: Despite the health plans' differences in size and organization—and the inherent difficulty collaborating with market competitors, participants derived many benefits from the collaborative, as noted in a 2006 evaluation report from Mathematica Policy Research:
- "Firms are much more aware of the value of race/ethnicity data in supporting quality improvement efforts targeting racial and ethnic disparities … and now say the goal is to capture race/ethnicity [data] for all of their members."
- "As firms gained insights on disparities, they began to think more concretely about what they, as firms sponsoring diverse health plans, could do to reduce disparities."