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Press Release Date: August 17, 2005
An increasing percentage of black enrollees in Medicare managed care plans are being screened for breast cancer or treated for diabetes or heart disease in accordance with nationally recognized quality measures, according to a new study in the August 18 issue of the New England Journal of Medicine. The study was supported by Health and Human Services' (HHS) Agency for Healthcare Research and Quality (AHRQ) and Health Resources and Services Administration and by Brigham and Women's Hospital.
"The increasing focus on preventive medicine in our nation's health care system is leading to better health for all Americans, particularly minority communities," said HHS Secretary Mike Leavitt. "However, there is much yet to be done, and we remain committed to making continued progress to eliminate health disparities in this country."
Researchers at Brigham and Women's Hospital and Harvard Medical School in Boston found, for example, that the percentages of black enrollees with diabetes who had their low-density lipoprotein (LDL) or "bad cholesterol" levels measured rose from 61 percent in 1999 to 92 percent in 2003—a 31 percent gain. The percentage of black enrollees with diabetes who had their LDL levels controlled increased even more—by 46 percent (from 23 percent in 1999 to 66 percent in 2003). White enrollees' rates also improved for both measures, but the gains made by blacks narrowed their gaps with whites from 9 percent to 2 percent for LDL testing and from 13 percent to 7 percent for LDL control.
Similarly, the percentage of black and white enrollees prescribed a beta-blocker drug within 7 days of hospital discharge following a heart attack, heart bypass surgery, or angioplasty rose, respectively, from 64 percent to 93 percent and 76 percent to 94 percent between 1997 and 2002. This progress resulted in many more blacks and whites getting optimal care, and also narrowed the gap from 12 percentage points to only 1 percentage point between blacks and whites with cardiovascular disease.
Blacks fell further behind whites on only one quality measure. The proportion of black enrollees with diabetes who had their blood sugar levels controlled according to nationally recognized clinical performance standards rose only 8 percentage points (from 67 percent to 75 percent), while for whites the numbers rose 11 percentage points (from 71 percent to 82 percent).
"Overall, these findings clearly show that progress is being made to reduce and eventually eliminate disparities in health care; however, much more work needs to be done," said AHRQ Director Carolyn M. Clancy, M.D. AHRQ is leading federal research efforts to develop knowledge and tools to help eliminate health care disparities in the United States and produces the annual National Healthcare Quality Report and National Healthcare Disparities Report.
The researchers, who were led by Amal N. Trivedi, M.D., and John Z. Ayanian, M.D., analyzed Health Plan Employer Data and Information Set (HEDIS) measures involving 1.5 million individuals enrolled in 183 Medicare managed care plans over the study period. Health plans participating in Medicare have been required to submit publicly reported data using specific HEDIS quality indicators since 1997.
Details are in "Trends in the Quality of Care and Racial Disparities in Medicare Managed Care," in the August 18 issue of the New England Journal of Medicine.
For more information, please contact AHRQ Public Affairs: (301) 427-1539 or (301) 427-1855.