Medicaid managed care plan leaders do not consistently use quality metrics to address disparities

According to findings reported in “The Role of Data in Health Care Disparities in Medicaid Managed Care,” published in Volume 2, Issue 4 of the Medicare & Medicaid Research Review, leaders at Medicaid managed care plans in California do not routinely use quality metrics, such as HEDIS, to assess disparities despite having access to data on beneficiary race and ethnicity. While leaders described efforts to improve overall quality as driven by standardized metrics, this did not hold for efforts to reduce disparities. Data were frequently only examined by race and ethnicity when overall performance on a measure was low. Disparities were attributed to either individual choices or to cultural and linguistic factors, with plans focusing interventions on recently immigrated groups, despite trends in HEDIS measures that often did not support this focus.

Read the full article:

http://www.cms.gov/Research-Statistics-Data-and Systems/Research/MMRR/Downloads/MMRR2012_002_04_A02.pdf

Citation:

Moskowitz, D., Guthrie, B., & Bindman, A. B. (2012). The Role of Data in Health Care Disparities in Medicaid Managed Care. Medicare Care & Medicaid Research Review, 2(4), E1–E15.