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Reducing Racial and Ethnic Disparities in Medicaid Managed Care

This toolkit, based on the experiences of a workgroup of Medicaid managed care organizations, provides strategies for reducing racial and ethnic health disparities. It includes case studies and lessons in the use of data to identify disparities, develop patient-centered approaches to care, and collaborate with key stakeholders.

The Issue: Compared with white Americans, members of racial and ethnic subgroups encounter more barriers to care, greater incidence of chronic disease, lower quality of care, and higher mortality. As many as half of Medicaid's 52 million beneficiaries are members of racial and ethnic minority subgroups and over 60 percent of all beneficiaries are enrolled in managed care. Thus, Medicaid managed care plans are uniquely positioned to identify and address disparities in health care utilization and outcomes.

Organizations: Center for Health Care Strategies (CHCS); Robert Wood Johnson Foundation; The Commonwealth Fund

Target Audience: Medicaid managed care organizations and state agencies

The Intervention: This toolkit is based on the experiences of a collaborative workgroup of Medicaid managed care organizations—called Improving Health Care Quality for Racially and Ethnically Diverse Populations—which was designed by the CHCS and supported by the Robert Wood Johnson Foundation and The Commonwealth Fund. The workgroup included 11 Medicaid health plans and one state primary care case management program. The members worked together from 2004 to 2006 to develop strategies to identify members of racial and ethnic subgroups, measure the gaps in care, and improve health care quality. The workgroup focused on disparities in three areas: birth outcomes and immunizations, asthma care, and diabetes care.

The first section of the toolkit includes information and guidance on collecting and analyzing data; designing patient-centered and culturally sensitive care; and encouraging collaboration with organizations such as hospitals, community leaders, and others.

Case studies, drawn from the experiences of the 12 participating organizations, summarize their accomplishments as well as roadblocks they encountered. Topics include:

  • The Rochester-based Monroe Plan for Medical Care Inc.'s Healthy Beginnings Program, which aimed to address high neonatal intensive care unit utilization and low prenatal care rates among African American enrollees;
  • Blue Cross of California State Sponsored Business's Asthma Pharmacy Consultation Program, which set a goal of increasing the rate of pharmacy consultations among eligible African American members with asthma from 45 percent to 52 percent through targeted pharmacy and member interventions; and
  • SoonerCare Choice's goal of improving care for adult American Indians with diabetes by improving the HEDIS 2006 screening scores.

The toolkit also includes a resource section that provides links to online tools used by the participating organizations, such as Monroe Health Plan's Healthy Beginnings Prenatal Registration Form and L.A. Care Health Plan's Pharmacy Ancillary Labels, which provide appropriate dosage information in 10 languages.

For More Information: For the complete toolkit, visit or contact January Angeles at [email protected]. Additional information is available in the "National Health Plan Collaborative: Phase One Summary Report," published in November 2006, also available at

January 2007

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