Quality agency, insurers fight ethnic care gap

Promising to "go beyond research and actively tackle racial and ethnic inequities" in health care delivery, the U.S. Agency for Healthcare Research and Quality is partnering with nine major health insurance plans in a collaborative effort to reduce ethnic and racial disparities in health care for people with diabetes.

Over the next three years, AHRQ and its partners will collect and analyze race and ethnicity data, compare those data with the Health Plan Employer Data and Information Set quality measures and develop interventions to close those gaps.

AHRQ Project Officer Cynthia Palmer said a goal of the partnership is to reduce poor outcomes that can be specifically traced to racial and ethnic disparities. Once successful interventions are developed, Palmer said, information on those interventions will be made available to other plans.

Palmer said the initiative was still in the planning stages but most likely would take the form of a series of pilot projects. The role of primary care physicians in this effort will depend on the focus and approach the individual health plans take, she said.

AHRQ's 2003 report on health care quality in the United States showed that only one-fifth of all diabetics received recommended routine health care services such as eye exams, hemoglobin A1c tests, foot exams and cholesterol screenings. AHRQ's 2003 report on health care disparities stated that blacks, Hispanics and people in poor neighborhoods were less likely to receive recommended care and, consequently, are hospitalized more for diabetes complications.

Study researchers calculated that, among a population of 100,000, there would be 291 African-Americans hospitalized for diabetes complications, 176 Hispanics and 88 whites.

The study also found that twice as many black people with diabetes -- 7.0 per 1,000 -- must have a foot amputated as white people with diabetes, who have an amputation rate of 3.5 per 1,000.

The health plans participating in the initiative are Aetna, CIGNA, Harvard Pilgrim Health Care, HealthPartners, Highmark, Kaiser Permanente, Molina Healthcare, UnitedHealth Group and WellPoint.