Addressing Disparities: The Path To Health Equity

November 18, 2020 · Amy Maciejowski

The brutal disparities in health care and social justice laid bare in 2020 demand action. That starts with identifying and understanding the groups being harmed or underserved. 

As public health care purchasers look to address the issues within their purview, many find that existing data cannot provide the insight they need on the racial, ethnic, and linguistic make-up of their members.  Without this information, it is extremely difficult to target interventions and measure progress. 

This week, NCQA convened a group of over 200 public sector stakeholders representing ten federal agencies and 45 states and territories, to discuss how our Multicultural Health Care Distinction (MHC) program is being used as the foundation for comprehensive efforts to  address disparities and improve outcomes for diverse populations.  Attendees heard from state practitioners and research professionals on a number of themes. 

• How states can wrap health equity and data collection standards into their managed care contracts. 
• The applicability of MHC to organizations other than health plans (e.g. hospitals). 
• The collective interest among states in implementing disparity reduction strategies. 
• The essential role of member trust as a factor in improving race and ethnicity data capture. 
• Strategies for capturing race and ethnicity data through enrollment and/or self-identification.  
• How requiring MHC Distinction can demonstrate a commitment to health equity and gain critical resources for the effort. 

Specifically, panelists at the webinar shared their experiences implementing equity strategies and discussed how MHC enables success in this area.   

Improved Outcomes in Pennsylvania 

Pennsylvania Medicaid collects member–level demographic data as part of their long-standing health equity goals.  This has enabled the program to look at rates by race, ethnicity, county, etc. The state decided to expand their initiative in 2019 by requiring their physical health plans to achieve NCQA Multicultural Health Care Distinction.  

The requirement has already paid off. The plans that have obtained the Distinction have shown improvement in quality of care: plans showed a 5.65 versus 2.15 percentage point improvement for the African American population relative to the white population for the “Controlling High Blood Pressure” measure.  

HMA Report Finds MHC Promotes Structural Impacts & Achievement of Health Equity 

The authors of a recent Health Management Associates (HMA) report described their analysis of the Multicultural Health Care Distinction program as a fit for Covered California’s mandate to address health disparities in the state. They found that MHC helps standardize the collection and use of data on race, ethnicity, and language. While health plans were motivated to achieve this Distinction, the requirements went one step further in allowing plans to address educational gaps externally and internally and created concrete steps to address health disparities and advance cultural responsiveness.  

Now What? 

Despite the positive outcomes and sound research, there is still a lot of work to be done.  

As NCQA continues to work in the health equity space, we look forward to continued engagement with our public sector partners. Feel free to send any questions to publicpolicy@ncqa.org.  

In the meantime, check out these additional resources on NCQA’s Multicultural Health Care Distinction: 

• Multicultural Health Care Distinction, Addressing Disparities & COVID-19  
• Multicultural Health: The Golden State’s Analysis and Implications for Your State 
• NCQA Social Determinants of Health Resource Guide 
• Multicultural Health Care Distinction Fact Sheet 
• Building an Organizational Response to Health Disparities: Inventory of Resource for Standardized Demographic and Language Data Collection