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Reducing Disparities

Blog Posts tagged "Reducing Disparities"

At Covered California’s latest April Board meeting, Executive Director Peter Lee declared: “We are raising the bar not just for California but for the nation.” Mr. Lee was referring to the bold initiatives adopted by the Covered California board that they expect will improve quality of care for Covered California enrollees, make advances in hospital safety, and promote primary prevention and wellness. The contracts will include 45 separate distinct requirements on plans focused on improving health outcomes for Covered California enrollees (See Attachment 7).

Starting in 2017, Covered California’s contracts will require health plans to demonstrate year-over-year reductions in health disparities in four targeted areas of chronic disease: diabetes, asthma, hypertension and behavioral health. In order to accurately measure disparities, health plans will be required to share quality and performance data for all their lines of business. Additionally, plans will be required to increase the percentage of self-reported demographic data for their Covered California enrollees with a goal of 80% of enrollees reporting by the end of 2019.

Covered California Sees Strong Enrollment Numbers in 2016: Covered California released a detailed breakout of its 2016 enrollees at its Board meeting on February 18. Nearly 440,000 new enrollees had selected a Qualified Health Plan (QHP) as of February 6, 2016. Low-income (88%) and communities of color (66%) continue to represent the majority of Exchange enrollees with Asians at 20%, Pacific Islanders at >1%, Black or African-American at 4%, Latino at 36%, American Indian or Alaskan Native at > 1%, and multiple races/other at 7%.

While Covered California’s preliminary enrollment numbers are strong, they provide an incomplete picture of the enrollee population as close to one-third of enrollees (119,510) did not respond to demographic questions. Covered California plans to provide additional data on its 2016 enrollee population including information on the written and spoken languages of its enrollees at a later point this year.

In order to adequately address health disparities, it is important to have as much information as possible on where inequities exist and what populations are most impacted. One of the best ways to address disparities is through collection of disaggregated data on race, ethnicity, and language spoken. One of the key aspects of CPEHN’s policy agenda is enhancing the collection and use of this data to develop more detailed and targeted strategies for reducing disparities.

This week, the California Health Report looked at how data collection can be used to reduce disparities experienced by children in the Medi-Cal program. In particular, the story focused on how children’s health advocates are pushing for Medi-Cal to report on more quality measures besides the minimum required:

The federal Centers for Medicare & Medicaid Services, which regulates the Medi-Cal program, has a list of 24 child health indicators this year. States are required to report on the quality of their low-income health programs, but filing data on the 24 indicators is optional…

California reported on 13 of the indicators in April and expects to report on the same ones when it files next year’s report, which will use 2015 data, said DHCS spokeswoman Carol Sloan.

Advocates argue that California should take the lead in reporting more quality measures because it has the largest Medicaid population in the country.

CPEHN’s Cary Sanders is featured in the story and discusses how reporting on more quality measures in Medi-Cal would help inform efforts to reduce disparities.

Earlier today, the UCLA Center for Health Policy Research hosted a webinar to look at the current state of available data on sexual orientation and gender identity and how the California Health Interview Survey (CHIS) has played a key role in improving collection of this data.

The event, The Importance of CHIS in LGBT Research and Data Collection, featured a presentation by Gary Gates, the Blachford-Cooper Distinguished Scholar and research director at the UCLA Williams Institute. Dr. Gates focused on how CHIS, a comprehensive population-based health survey, has been collecting sexual orientation over the past decade. Over that time span, Dr. Gates said, public perception has been shifting and many states have passed legislation legalizing same-sex marriage and other benefits. The demographic data available through CHIS shows the impact of this shift in public perception, and Dr. Gates expressed excitement about continued improvement in the future, particularly in regards to gender identity data.

Dr. Gates highlighted some specific trends over the past decade by looking at a variety of demographic data, including age, income, and race/ethnicity. He found that younger people and people of color are identifying as lesbian, gay, or bisexual at a higher rate than they were 10 years ago and that this is likely the result of changing societal perceptions.