Each
of the eleven member health plans is evaluating provider-, member- and
community-targeted approaches that use race and ethnicity data so we can
see how effective these approaches are at reducing gaps in care and improving
the quality of care racial and ethnic populations receive. More specifically, the Collaborative is currently developing recommendations and resources to encourage and guide primary racial and ethnic data collection to assist in identifying and addressing disparities, developing tools and guidelines to improve language access, making a business case for addressing disparities and calculating the return on investment of disparities-related initiatives, and working to improve knowledge management and dissemination of disparities-related information.
Currently, member health plans are contributing data from
these initiatives to the Collaborative in the following ways:
Aetna is testing an outreach strategy
to providers and nurses to improve diabetes screenings for African-American
members. As part of the project, Aetna has developed a cultural sensitivity
training module available to all staff and a nursing education program.
Aetna is using a number of communication channels to reach physicians
and members.
CIGNA has conducted an extensive analysis
of its diabetic members and is testing a disease management program focusing
on medication use and compliance. Based on the management program results,
CIGNA is developing specific internal and community outreach strategies
to improve the care diabetic members receive.
Harvard Pilgrim Health Care is testing
a community-based intervention program designed to ensure diabetic Hispanics
receive timely eye exam screenings. The outreach effort includes a local
business partner and a media outreach plan to get the word out in the
community.
HealthPartners is working to establish baseline race, language preference and country of origin patient data by collecting this information at HealthPartners Clinics and Regions Hospital. HealthPartners is also collecting this information from its health plan members on healthpartners.com. Other quality improvement efforts include offering on-site and telephone interpreting services to doctors and patients in more than 150 languages and maintaining and expanding a cross cultural care intranet site for providers.
Highmark Inc. has analyzed multiple data sources to identify health disparities in its membership. Based on this analysis, education programs and collaboration with physician practices were initiated in communities where diabetes disparities exist. Targeted member interventions promoting the importance of screenings and diabetes management are in progress. Ongoing community-based interventions that reduce disparities and improve health include partnerships and programs with faith-based and advocacy groups, hospitals, community health centers and general and minority media.
Humana is working to establish baseline race, ethnicity and language data through primary and geo-coded data collection. Humana maintains language translation services for members, which provide full service language interpretation and translation over the phone, with one hundred and fifty languages available. A number of member educational materials are available in both English and Spanish. Members can identify providers who meet their language preference through the Humana web-based "Physician Finder" or by contacting a Member Service representative. In addition, Humana associates have available on-line cultural diversity courses, including Spanish language tutorials, through the company's Diversity Resources Center.
Kaiser Permanente is developing a culturally competent outreach model to reduce cardiovascular mortality among its Hispanic members with diabetes. "Focused on A.L.L." (Aspirin, Lisinopril, Lovastatin) integrates community partners, population management principles and clinical teams to dramatically reduce cardiovascular risk for patients with diabetes.
Molina Healthcare is testing a diabetes
self-management program with members, providing 24/7 access to bilingual
English/Spanish-speaking staff who are knowledgeable about the program.
Molina is also initiating discussions with providers to ensure all information
about the patient that is passed between the provider and the health plan
is consistent.
UnitedHealth Group is using geo-coded
data to identify physicians in areas with documented disparities and sending
them information on how to address those disparities. Member-based interventions
involve partnerships with English-, Chinese- and Spanish-language multicultural
programs.
WellPoint, Inc. is also using geo-coded
data to identify physicians and members in areas with documented disparities.
Physicians in pilot regions will receive cultural competency toolkits,
as well as culturally and linguistically adapted patient education materials
to support their efforts in caring for a diverse population. Members with
eligible chronic disease conditions in identified regions with documented
disparities will receive enhanced disease management outreach efforts
and programs. For its community support initiative, WellPoint is collaborating
with the California Division of the American Cancer Society to develop
a version of the highly successful Body and Soul Program, an African-American
church-based health education curriculum, for the Hispanic community.
Over the life of the project, the National Health Plan Collaborative will
build upon its work and engage other health care decision-makers, such
as major health care insurance purchasers, health care providers and policy-makers,
to join ongoing efforts to find solutions to racial and ethnic disparities
in health care.
The National Health Plan Collaborative released its Phase One Summary Report on November 2, 2006 at the AHIP Medical Leadership Forum in Phoenix, Arizona.
Click here to read the report.
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