Racially and ethnically diverse populations experience more barriers to care, lower quality, and a disproportionate burden of illness from chronic diseases. The Centers for Medicare and Medicaid Services indicate that in 2001, nearly half of the 31 million beneficiaries of Medicaid were culturally diverse Americans. Consequently, state Medicaid purchasers and their managed care contractors are uniquely situated to test and generate improvements in the quality of care and health outcomes for millions of racially and ethnically diverse beneficiaries with chronic illnesses. They can do so by aligning contracting requirements, data capabilities, financing incentives, cultural competence, and disease management proficiencies.

Twelve states participated in this CHCS Purchasing Institute that worked with state Medicaid agencies to enhance data collection and analysis skills, build agency capacity, and create a strategic plan for quality improvement projects focused on health disparities.

CHCS developed the following guiding framework to serve as the basis of the Purchasing Institute curriculum:

  1. Data – Obtaining accurate racial and ethnic data and developing the tools needed to analyze these data to identify health disparities.
  2. Actions – Types of actions (administrative, purchasing strategies, and policy changes) a state can pursue once it has data that allows staff to determine where disparities exist.
  3. Communication – Development of a communications plan that helps a state efficiently and effectively communicate its vision for reducing disparities.