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Major health plans and organizations join AHRQ in working to reduce racial and ethnic disparities in health care

The Agency for Healthcare Research and Quality has announced a new public-private partnership, the National Health Plan Learning Collaborative to Reduce Disparities and Improve Quality, which is designed to help reduce disparities in health care for people with diabetes and other conditions. This collaborative brings together nine of the Nation's largest health insurance plans: Aetna, CIGNA, Harvard Pilgrim Health Care, HealthPartners, Highmark Inc., Kaiser Permanente, Molina Healthcare, UnitedHealth Group (UnitedHealthcare, Ovations and AmeriChoice), and WellPoint, Inc., as well as several other organizations.

This collaborative is the first national effort of its kind to go beyond research and actively tackle racial and ethnic inequities in health care service delivery. Nationally, only one-fifth of patients with diabetes receive routinely recommended health care services, including eye exams, flu shots, blood sugar (hemoglobin A1c) tests, foot exams, and cholesterol screening, according to AHRQ's National Healthcare Quality Report released in December 2003. Blacks, Hispanics and people who live in poor neighborhoods are even less likely to receive these services and consequently are hospitalized more often for complications of diabetes, according to AHRQ's National Healthcare Disparities Report. The 2004 versions of both reports are expected to be released soon.

To guide quality improvement activities, a key goal of the collaborative is to address and reduce barriers to data collection to facilitate identification of disparities. A study by America's Health Insurance Plans (AHIP) and The Robert Wood Johnson Foundation (RWJF) earlier this year found that approximately one-half of all health plans now collect data on the race and ethnicity of their members to help the plans reduce disparities in health care. However, the study also found that companies continue to cite barriers to data collection, especially concerns about the perceptions of members and local communities, difficulties in obtaining reliable data, and questions about limitations that may exist in Federal and State laws or regulations.

Over the next 3 years, the collaborative will test ways to improve the collection and analysis of data on race and ethnicity, match the data to existing quality measures in the Health Plan Employer Data and Information Set (HEDIS), develop quality improvement interventions that close the gaps in care, and produce results that can be replicated by other health insurers and providers serving Medicare, Medicaid, and commercial populations. The goal is to share the lessons learned by plans in the collaborative with other health plans so that they too can improve the care they provide.

To further the aims of this unique collaboration, AHRQ has joined with RWJF, which is supporting the Center for Health Care Strategies and the Institute for Healthcare Improvement, to provide expertise in the areas of data collection, quality improvement, and evaluation. The RAND Corporation is also sharing its expertise in these areas. In addition, AHIP and the Blue Cross and Blue Shield Association will participate in the work of the collaborative.

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