Academy Health: 2016 Disparities Interest Group CMS Office of - - PowerPoint PPT Presentation

CMS Office of Minority Health

Madeleine Shea, Deputy Director June 25, 2016

Academy Health: 2016 Disparities Interest Group

Mission

To ensure that the voices and the needs of the populations we represent (racial and ethnic minorities, sexual and gender minorities, rural populations, and people with disabilities) are present as the Agency is developing, implementing, and evaluating its programs and policies.

Vision

All CMS beneficiaries have achieved their highest level

• f health, and disparities in health care quality and

access have been eliminated.

CMS OMH Mission and Vision

• A four-year strategic plan that includes six

priority areas

• First CMS plan to address health equity in

Medicare

• Identifies multilevel solutions to reduce

disparities in Medicare.

• Read the CMS Equity Plan for Medicare at

go.cms.gov/cms-omh

CMS Equity Plan for Medicare

Equity Plan Priority Areas

Priority 1: Expand the Collection, Reporting, and Analysis of Standardized Data Priority 2: Evaluate Disparities Impacts and Integrate Equity Solutions Across CMS Programs Priority 3: Develop and Disseminate Promising Approaches to Reduce Health Disparities Priority 4: Increase the Ability

• f the Health Care Workforce

to Meet the Needs of Vulnerable Populations Priority 5: Improve Communication & Language Access for Individuals with LEP & Persons with Disabilities Priority 6: Increase Physical Accessibility of Health Care Facilities

Mapping Medicare Disparities (MMD) Tool

Released in March 2016 Interactive

Can be accessed here: https://www.cms.gov/about-cms/agency- information/omh/OMH-Mapping-Medicare-Disparities.html

MMD Tool Measures

• 100% 2012-2014 Medicare beneficiary fee-for-service claims
• Prevalence
• CVD, Diabetes, Chronic Kidney Disease (CKD), Multiple Chronic Conditions

(MCC)

• Hospitalization Rates
• 18 different chronic conditions & MCC
• Average Costs
• 18 different chronic conditions
• Emergency Room Visit Rates
• Avoidable Hospitalization Rates
• Diabetes Complications, Hypertension, Congestive Heart Failures,

Pneumonia, and more

• Cause-specific Mortality Rates
• Acute Myocardial Infarction and Heart Failure

This tool can help you visualize disparities and develop targeted strategies to reduce the disparities between different racial and ethnic groups.

MMD Tool Features

The MMD Tool allows comparison of chronic disease conditions between (diabetes example):

• Compare the cost of diabetes across states in the

U.S.

State & national averages

• Compare the cost of diabetes across different

counties within a state

Geographic regions

• Compare the cost of diabetes between men and

women, different age groups, or between different racial and ethnic groups within a specific county

Groups within the same geographic area

MMD Tool Features

The MMD Tool Can:

• Enable visualization and cost/trend analysis of existing

healthcare disparities, which are linkable at the national, state, or county level

• Aid development of targeted research to quickly

calculate disparities existing between different racial groups

• Increase access to risk-adjusted cost, readmission, and

prevention quality indicator measures to study healthcare cost and quality rates

MMD Tool Features

The MMD Tool Can:

• Provide a resource for researchers to easily identify,

view, and download, and analyze data on the health issues in their area and gauge change in those issues over time

• Provide a resource for government agencies, health

policy makers, researchers, and members of the general public with an interest in health disparities

Which counties in New Mexico have the largest discrepancies in diabetes costs among Hispanic populations when compared to state diabetes costs among Hispanic populations?

Example Disparities in Diabetes Costs

The cost of diabetes among Hispanics in Union County is 1.5 times that of the statewide costs for Hispanics. The cost of diabetes among Hispanics in De Baca County is 1.3 times that of the statewide costs for Hispanics.

Union County (NM) County Hispanic Total Cost: $18,201 New Mexico Hispanic Total Cost: $12,001 Difference in Total Cost: $6,200 De Baca County (NM) County Hispanic Total Cost: $16,052 New Mexico Hispanic Total Cost: $12,001 Difference in Total Cost: $4,051

Example Disparities in Diabetes Costs

In New Mexico, what county has the largest with-in county difference in diabetes costs between racial and ethnic groups?

Union County (NM) Hispanic Total Cost: $18,201 White Total Cost: $13,673 Difference in Total Cost: $4,528

The average cost of diabetes among Hispanics in Union County is 1.3 times that of White average costs.

Example Reduce Preventable Admissions

In Florida, which county has the highest disparities in rates for avoidable hospital admissions for diabetes?

In Okeechobee County, the rate for avoidable hospital admissions for diabetes among African Americans is 6.7 times higher than the rate for Whites.

Okeechobee County (FL) Black Hospitalization: 40 per 1,000 beneficiaries White Hospitalization: 6 per 1,000 beneficiaries Difference in Hospitalization: 34 per 1,000 beneficiaries

Download the Data Example – Diabetes Costs in Florida Counties, By Race & Ethnicity and Insurance Type

Among selected Florida counties, the difference in costs between Black and White Medicare beneficiaries differs by

• county. In Miami-Dade there are higher costs for black

populations; the reverse is true in Liberty County. Among selected Florida counties, Miami-Dade County has the largest discrepancy between Black and White populations in the total amount paid per beneficiary for diabetes.

Average Total Cost per Beneficiary – Diabetes: Florida Counties, 2014

County Dual & Non Dual Beneficiaries Medicare Only Beneficiaries Black Beneficiaries White Beneficiaries Difference in cost between Black and White Beneficiaries Black Beneficiaries White Beneficiaries Difference in cost between Black and White Beneficiaries Lake $18,062 $13,244 $4,818 $13,083 $12,752 $331 Lee $17,187 $13,220 $3,967 $14,259 $12,632 $1,627 Leon $15,934 $12,903 $3,031 $11,706 $11,954

• $248

Levy $22,928 $14,448 $8,480 $13,604 $11,551 $2,053 Liberty $17,649 $11,941 $5,708 $10,149 $11,596

• $1,447

Madison $13,636 $11,549 $2,087 $10,574 $10,802

• $228

Manatee $19,738 $13,634 $6,104 $13,009 $12,619 $390 Marion $17,289 $13,573 $3,716 $12,968 $12,657 $311 Martin $17,693 $14,655 $3,038 $15,074 $14,108 $966 Miami-Dade $28,943 $18,588 $10,355 $19,606 $15,761 $3,845 Monroe $18,283 $14,539 $3,744 $14,772 $12,867 $1,905

Data can be downloaded and manipulated in Excel

Madeleine Shea, Deputy Director, CMS OMH Madeleine.Shea@cms.hhs.gov CMS OMH Homepage: go.cms.gov/omh

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