Multicultural Health: The Golden State’s Analysis and Implications for Your State
November 2, 2020 · Matt Brock
California leads the way in a number of areas—technology, environmental protection, wine. When it comes to healthcare, what stands out is the state’s trailblazing Covered California exchange. The largest and most influential of the state-run marketplaces created under the Affordable Care Act, it has proven a model for holding down costs for consumers while demanding that insurers offer high-quality health plans that include good benefits.
Leading on Health Equity
Covered California has also been squarely focused on addressing one of the most important issues facing healthcare and policymakers in 2020—the disparities in access and outcomes experienced by certain racial and ethnic groups and those facing language and cultural barriers.
The state recognizes that you cannot address this complex problem until you can quantify it, identify and apply solutions, and then measure your improvement. That first step requires that plans have detailed information on their populations, especially the groups that have historically seen poorer results.
Sounds simple enough but the facts on the ground belie this assumption. One way to measure the “demographic awareness gap” is to look at how many plans have complete racial, ethnic and linguistic data on a majority of their members. Recent findings show that 75% of commercial plans don’t and only 1 in 10 has complete data on their entire population.
Covered California recently hired nationally recognized independent research and consulting firm Health Management Associates (HMA) to analyze how requiring Multicultural Health Care Distinction would support the state’s goals for addressing health equity – including understanding the demographics of the plans offered on the exchange—as part of a larger assessment of how well they hold health plans accountable for quality.
We are honored to report that they cited NCQA’s Distinction in Multicultural Health Care (MHC) program as an important tool in addressing disparities. Specifically, they found that:
“A growing volume of research and best practices demonstrate that achieving health equity requires policy-level changes and resource allocation or reallocation. We recommend that Covered California express its commitment to health equity by changing the language in Article 3.04, requiring Issuers to achieve NCQA Distinction in Multicultural Health Care. This policy-level change can impact Issuers’ resource allocation (staffing, funding) to deliberately address disparities and health equity, increasing infrastructure and reinforcing organizational commitment to this work”
Our program provides external validation that an organization is aligned with industry practices and is following evidence-based guidelines. Organizations with MHC Distinction demonstrate that they collect race/ethnicity and language data on patients and practitioners to improve language assistance and cultural responsiveness and reduce health care disparities.
More to Do
NCQA believes that the requirements of our MHC program are an important first step in the long journey toward health equity. But we know it is not enough. We are collaborating with policymakers, plans, providers and anyone else who shares our mission of providing quality care to all patients on developing programs and services that address the inequalities of the healthcare system. We consider this some of our most important work and look forward to being part of the movement for years to come.
Addressing health disparities starts with understanding the unique demographics of your population. It is more crucial than ever given recent turmoil and the ongoing pandemic’s disproportionate impacts. All of us understand the urgent need to act on the inequities that plague our health care system. As a result, public purchasers are getting innovative to pinpoint and improve outcomes for their entire population and looking to NCQA’s Multicultural Health Care Distinction to help.
To learn about this, please join us on November 16th, for a national webinar: “Paving the Road to Address Disparities: The Public Sector Perspective on NCQA’s Multicultural Health Care Distinction” where we’ll feature representatives from Pennsylvania Medicaid sharing how NCQA’s Multicultural Health Care Distinction fit into their health equity strategy. In addition, the authors of the recent Health Management Associates (HMA) report will describe their analysis of the program as a fit for Covered California’s requirements to address health disparities in the state.