BOSTON, Sept. 23, 2021 /PRNewswire/ -- Blue Cross Blue
Shield of Massachusetts (Blue
Cross) today shared the results of a new analysis of racial and
ethnic inequities in health care and became the first health plan
in Massachusetts to announce it
will incorporate equity measures — differences in the quality of
care across racial and ethnic groups — into its contracts and
payment programs with clinicians who care for Blue Cross
members.
In keeping with a commitment announced earlier this year to
act as a leader in addressing health inequities, the company
reviewed 2019 administrative and health data from more than 1.3
million Massachusetts members and
identified racial disparities that, in many cases, represent
lower-quality care for Black, Asian, and Hispanic members on 48
industry-standard measures that Blue Cross tracks as part of its
ongoing quality assurance operations. The data are now accessible
to the public at
https://www.bluecrossma.org/myblue/equity-in-health-care/health-equity-report.
"It has long been known that racial inequities have devastating
consequences across American health care, and the pandemic has made
that clear to all of us in the past year," said Blue Cross
president and CEO Andrew Dreyfus.
"Measurement is a critical first step in addressing those
disparities. We're publishing these results to hold ourselves
accountable for progress toward our goal of eliminating racial
inequities in the care our members receive."
For its analysis, Blue Cross examined disparities across a range
of categories for children and adults, including preventive and
condition-specific care. For care delivered in 2019 to commercial
members, examples of the company's findings include:
- Asian, Black, and Hispanic members were less likely than White
non-Hispanic members to receive screenings for colorectal cancer
(67.0% for Asian, 63.8% for Black, 65.4% for Hispanic, vs 70.8% for
non-Hispanic White members)
- Rates of severe maternal morbidity (life-threatening medical
issues during childbirth) for Black commercial members were more
than double that of White non-Hispanic members (2.8% vs 1.2%)
- Rates of adolescent well-care visits were lower for Black and
Hispanic members than for White non-Hispanic members (68.9% for
Black, 70.3% for Hispanic vs 80.2% for non-Hispanic White
members)
- Black and Hispanic members were approximately 15-20% less
likely than White non-Hispanic members to receive recommended
antidepressant medication management
Full results available
at https://www.bluecrossma.org/myblue/equity-in-health-care/health-equity-report
In addition to releasing these findings publicly, Blue Cross has
shared with its clinical partners more detailed data showing how
their practices compare with others in terms of racial inequities
in care. Blue Cross' employer customers will have the option of
receiving similar data for their employees.
"We're committed to working collaboratively with the medical
community to identify the underlying causes of racial inequities
and to find ways to close these gaps," said Dr. Sandhya Rao, Blue Cross' chief medical officer.
"We know clinicians can't do this alone – we have a shared
responsibility to address and eliminate inequities, and our
collective efforts will ultimately improve health care for all our
members, across every racial and ethnic group."
Equity Measures and Payment Models
One of the primary
ways Blue Cross will address inequities in its members' care is by
incorporating equity measures into its payment models starting in
2023.
Blue Cross and the Institute for Healthcare
Improvement (IHI) this month launched a new collaborative
intended to assist physicians and hospitals enrolled in the health
plan's value-based payment model in their efforts to improve
the equity of care and prepare them for equity-based financial
incentives linked to improvements in racial inequities in care.
"As a health plan, we have a responsibility to address
inequities directly with our members and by supporting the
clinicians who serve them," said Dr. Mark
Friedberg, senior vice president for performance measurement
& improvement at Blue Cross. "Our aim is to produce
meaningful, measurable, and sustainable improvements in the equity
of care. Payment is necessary but not sufficient to do this. So
starting now, we are sharing data on inequities and engaging our
provider network in collaborative efforts to address them."
"I am grateful for Blue Cross' commitment to improving the
equity of our health systems by encouraging its provider network to
view the urgency of the moment as a time to take decisive action,"
said Beya Jimenez, senior account
director at The Lazu Group and a member of Blue Cross' Health
Equity Council. "Through Blue Cross' leadership, we are witnessing
a unique approach to health equity that encompasses the values
needed to emerge triumphant against racial and systemic barriers in
health care."
Commitment to Addressing Health Inequities & Racial
Justice
Blue Cross' recent work to address racial
inequities also includes launching a fully in-house
Spanish-language member call center and making its website
available in five additional languages - Spanish, Portuguese,
Russian, Chinese (Simplified), and Vietnamese.
Blue Cross also supported a variety of statewide efforts to help
provide equitable access to COVID-19 vaccines, including funding
transportation, sponsoring the Vax Express, and partnering with
Equity Now & Beyond to host vaccine clinics and provide
educational outreach in immigrant communities across Massachusetts.
Additionally, the company launched new $350,000 Racial Equity and Justice grants to
support Black, Indigenous, People of Color (BIPOC)-led
not-for-profit organizations focused on addressing racial injustice
in Massachusetts communities. Blue
Cross will continue to provide additional direct financial support
via charitable investments to a wide range of organizations working
to advance racial equity and social justice.
The Blue Cross Blue Shield of Massachusetts Foundation has made
addressing racial inequities in health care one of its three focus
areas, along with access to care and mental health. The Foundation
works with its partners to identify policies that present barriers
to equitable access to health care and coverage for people of
color, and to diversify the workforce and leadership of health care
organizations. In addition, the Foundation this year launched seven
focus groups across the Commonwealth to discuss with BIPOC-led
organizations what they see as the solutions to structural racism
and racial inequities in health care.
Methodology
The member race and ethnicity data
underlying Blue Cross's analyses were imputed using the RAND
Bayesian Improved Surname Geocoding (BISG) method, which is a
commonly used approach when self-reported data are incomplete. It
is likely that analyses based on imputed data underestimate the
true magnitude of inequities. For this reason, Blue Cross is
currently engaged in a major effort to collect self-reported race
and ethnicity data from members directly. Future versions of these
analyses will transition from imputed data to member self-reported
race and ethnicity data.
Blue Cross invites members to share information about their
race, ethnicity, and preferred language when they log into the
company's member portal, MyBlue. Knowing more about its 2.8 million
members will help Blue Cross do its part to create a better, more
equitable health system.
About Blue Cross Blue Shield
of Massachusetts
Blue Cross Blue Shield of Massachusetts (bluecrossma.org) is a
community-focused, tax-paying, not-for-profit health plan
headquartered in Boston. We are committed to the relentless
pursuit of quality, affordable and equitable health
care with an unparalleled consumer
experience. Consistent with our promise to always put our
members first, we are rated among the nation's best health plans
for member satisfaction and quality. Connect with us on
Facebook, Twitter, YouTube, and LinkedIn.
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SOURCE Blue Cross Blue Shield of Massachusetts