St. Paul, Minn. (June 22, 2011) – A report from MN Community Measurement shows that while disparities are narrowing in quality of health care for low-income Minnesotans, significant gaps continue. Overall the quality of health care provided by managed care plans to people covered by public health care programs continues to lag when compared with care provided to patients who have insurance through an employer or Medicare, according to the annual report by MN Community Measurement.
“Although the report shows that there has been some narrowing of disparities in quality of care, serious gaps still remain,” said Human Services Commissioner Lucinda Jesson. “Reports like this are vital both for helping us focus on where we need to improve as well as for helping the public keep us accountable for that improvement. As we move forward with our payment and delivery system reforms, tracking improvement in disparities reduction will be an area we keep our eye on.”
The 2010 Health Care Disparities Report for Minnesota Health Care Programs is the fourth-annual report produced by MN Community Measurement in collaboration with DHS, which contracts with managed care plans to provide health care services for approximately 536,000 people enrolled in Medical Assistance and MinnesotaCare. The report includes performance rates on 12 specific measures, from preventive care, such as cancer screenings, to care for chronic illnesses, such as diabetes and high blood pressure.
The annual Minnesota Health Care Disparities Report is one of a growing number of tools – including the recently launched DHS public dashboard – that the department is using to track its performance and hold itself accountable to Minnesotans.
Looking at rates over time, there is some narrowing of gaps, with the biggest improvement being in cervical cancer screening. Overall performance, however, still showed nine of the 12 measures significantly lower for people with public program coverage versus private, with the widest gaps appearing for colorectal cancer screening, followed by optimal vascular care and breast cancer screening.
The annual reports have prompted one Twin Cities group of pediatricians to dramatically improve its performance rate on childhood immunizations for children with public program coverage. Two years ago Metropolitan Pediatric Specialists provided 48 percent of its public program patients with appropriate childhood immunizations. In 2010, after implementing changes based on report findings, it reached 85 percent.
That’s higher than the childhood immunization rate for all managed care providers across all patients. The rate for public program patients stayed at 75 percent for two years, while the rate for those with other insurance dropped from 80 percent in 2009 to 77 percent in 2010.
Dr. Tim Johanson, Metropolitan Pediatric Specialists’ quality director, said the group achieved the significant improvement by taking extra steps to allay fears some parents have about vaccine safety. Those extra steps include using a template in the electronic medical record that allows the doctor to recommend and track vaccine schedules that some parents want and counseling parents during well-child checkups.
“Parents need to have accurate and science-based information about vaccine safety and the public health benefits of vaccines,” Johanson said. “We feel that this topic now dominates our well-child checkups, so we spend a lot of time overcoming the myths about vaccine safety.”
This year marks the first time performance data is reported by clinic for the optimal diabetes care and optimal vascular care measures. This allows patients who have diabetes or vascular disease to find out which clinics are providing average, above average or below average care for those conditions. The top performer for optimal diabetes care was Affiliated Community Medical Centers-Litchfield Clinic (East) and for optimal vascular care was St. Mary’s/Duluth Clinic Medical Center-DC First St. Building.
Comparable data for more than two years is available for only half of the 12 measures. Future reports will allow analysis of additional measures over time.
MN Community Measurement is a nonprofit organization dedicated to improving the quality of health care in Minnesota by publicly reporting quality results. Founded by Minnesota’s health plans and the Minnesota Medical Association, MN Community Measurement is a collaborative that works with health plans, medical groups and physicians, employers and consumers to spur quality improvement, reduce health care costs and increase the value of health care. The 2010 report is available at www.mncm.org.