Eliminating Health Disparities Measurement and Data Needs (2004) / Chapter Skim
Currently Skimming:
Appendix G Racial and Ethnic Data Collection by Health Plans
Appendix G Racial and Ethnic Data Collection by Health Plans
Pages 272-287
The Chapter Skim interface presents what we've algorithmically identified as the most significant single chunk of text within every page in the chapter.
Select key terms on the right to highlight them within pages of the chapter.
From page 272... ...
, have demonstrated how race, ethnicity, and English proficiency can affect access to quality health care as the United States becomes a more racially and ethnically diverse nation. Health plans have recognized the importance of responding to patients' varied perspectives, beliefs, and behaviors about health and well-being, as well as the considerable health consequences that will result in a failure to value and manage cultural and communal differences in the populations they serve.
|
From page 273... ...
Health plans view the collection of data on the race and ethnicity of their members as having great utility in a number of areas, such as evaluating the differences in care being received by plan members; designing culturally appropriate educational and other member communications; and implementing clinical and service quality improvement activities. What follows is a description of interviews conducted across a sample of AAHP's1 member health plans, assessing their efforts to collect racial and ethnic data; offering examples of some current and potential methods of collection; identifying real and perceived barriers to data collection; and detailing the usefulness of such data for health plan programs.
|
From page 274... ...
AAHP was asked to evaluate whether and how health plans collect racial and ethnic data. The panel believed there would be value in using an interview method that provided for and encouraged interactive questioning.
|
From page 275... ...
The majority of respondents interviewed have been with their current health plan for 4 or more years, while less than a quarter of respondents were with health plans fewer than 4 years. Summary of Findings and Trends The health plans surveyed uniformly agree that the collection of racial and ethnic data is a part of good business practice.
|
From page 276... ...
At present, health plans are using racial and ethnic data in two major areas: to address preventive care issues within specific populations, and to identify populations at higher risk for certain chronic conditions. Other uses identified by health plans include the ability to apply a "loose evaluative" process to determine the consistency with which care is being delivered across different racial and ethnic groups -- especially with regard to specific conditions; to assess the "representativeness" of the data collected in member surveys (i.e., how accurately the data reflect the populations served)
|
From page 277... ...
For example, people from Mexico may use different dialects than individuals from Puerto Rico, although both are categorized as being of Hispanic/Latino descent. At this time there appears to be no consistent approach to collecting racial and ethnic data within and between health plans, or throughout the health care system.
|
From page 278... ...
Consumer Benefits Derived from the Use of this Information The health plans interviewed identified specific benefits and applications for the collection of racial and ethnic data. As might be expected, given their emphasis on preventive care, health plans most frequently responded that they use these data for addressing preventive care issues within specific populations and identifying populations at higher risk for chronic conditions.
|
From page 279... ...
For those health plans that operate in several states, multiple considerations increase the level of complexity. Although perceived otherwise by the public and across the health care industry, legal barriers to data collection on the race and ethnicity of their members are generally absent except in four states that have laws or regulations restricting health plans from collecting such data (see the review of both federal and state policies and regulations concerning the collection of racial and ethnic data at the end of this appendix)
|
From page 280... ...
contains a field for racial and ethnic data. Similarly, health plans are increasingly relying on electronic submission of enrollment data, yet HIPAA requires the use of the standard enrollment transaction (834)
|
From page 281... ...
Even if the HIPAA standard enrollment transaction were modified to make race and ethnicity required data elements and employers were to voluntarily adopt the modified standard, an enrollment transaction is usually generated only for new members in a health plan option and for those who change or terminate their coverage options. Therefore, collection of racial and ethnic data in the enrollment transaction alone will not provide information on the vast majority of health plan members who have not recently joined the plan or changed their coverage during a given year.
|
From page 282... ...
Although health plans have implemented many changes in data collection efforts, there is no universal approach to the initiation of racial and ethnic data collection and cultural competence activities. Forty-two percent of the health plans interviewed indicated they had a CEO-level task force/ directive; 33 percent stated that racial and ethnic data collection and cultural competence efforts were simply integrated into the "daily activities" of the health plan; 13 percent replied that they used both processes; and 13 percent indicated that they had no "formal" program in place.
|
From page 283... ...
CONCLUSIONS Health plans recognize that cultural diversity and beliefs offer numerous challenges for the health care industry, as well as opportunities. Plans are interested in participating in a coordinated, directed effort to accelerate the collection of accurate racial and ethnic data.
|
From page 284... ...
Regarding specific implementation efforts, while larger organizations have more flexibility in control of the human resources needed for change and to assemble task forces for this purpose, "going it alone" is not a viable option for the majority of health plans. For this reason, our respondents stated that the efforts they believed would be well received and prove most effective would include: regional collaborations; "mentorship" with smaller plans; coordinated public/private efforts toward the education of health plans and the health care industry regarding legal issues; information sharing and confidence building/assurances to the public about the intended and specific use of racial and ethnic data; and standardization of data collection methods.
|
From page 285... ...
This would include identification of specific factors that prevent culturally diverse populations from obtaining quality health care and how these factors interact with the health care system. Review of Federal Policies and Practices and State Laws Regarding Racial and Ethnic Data Collection Federal Level A study by The Commonwealth Fund (Perot and Youdelman, 2001)
|
From page 286... ...
-- have laws or regulations barring health plans from collecting data on race and ethnicity. This prohibition has a significant impact on racial and ethnic data collection, as these states have high HMO penetration rates: California, 48.5 percent; Maryland, 27.8 percent; New Hampshire, 25.9 percent; and New Jersey, 27 percent.
|
From page 287... ...
has certain regulations that prohibit the collection of racial and ethnic data under certain circumstances. Per the regulation, application forms for individual health insurance "shall not include questions that pertain to race, creed, color, national origin or ancestry of the proposed insured." The DBI prohibition is applied only in the narrow realm of insurance application forms and not at any other point of the process of providing coverage.
|
Key Terms
This material may be derived from roughly machine-read images, and so is provided only to facilitate research.
More
information on Chapter Skim is available.