BOSTON -- Numerous studies show the African-Americans receive worse quality of care relative to white Americans across a broad array of medical conditions--disparities that can significantly harm patients or reduce quality of life. A new study from Harvard Medical School and Brown Medical School shows that such disparities in care cannot simply be attributed to low-performing health plans. The research, published in the Oct. 25 Journal of the American Medical Association, shows that high-performing plans and low-performing health plans, based on four key health measures, have comparable levels of disparities in these measures while serving Medicare patients.
"Across Medicare health plans, better overall quality is not consistently associated with smaller racial disparities on four key outcome measures for enrollees with diabetes, hypertension, or heart disease," says John Ayanian, MD, MPP, associate professor of health care policy and of medicine at Harvard Medical School (HMS) and Brigham and Women's Hospital.
Ayanian, Amal Trivedi, MD, MPH, formerly of the Department of Health Care Policy at HMS and now an assistant professor of community health at Brown Medical School, and colleagues found only one health plan in a sample of 151 that had both high overall quality and low racial disparity on more than one of four outcome measures examined.
Since 1997, all health plans participating in Medicare have been mandated to report on quality of care using Health Plan Employer and Data Information Set (HEDIS) performance measures developed by the National Committee for Quality Assurance. The authors obtained HEDIS data for Medicare managed care plans, containing more than 431,000 observations from enrollees in 151 health plans.
For the four HEDIS outcome measures the authors examined, clinical performance was approximately 7 to 14 percent lower for black enrollees than white enrollees. More than 70 percent of the racial disparity o
Contact: Leah Gourley
Harvard Medical School