For decades, public health experts and policymakers have been concerned with health disparities and improving health outcomes for individuals from minority populations – and for good reason. Chronic diseases like diabetes, cardiovascular disease, arthritis, and asthma and allergic diseases are the leading cause of death, disability and illness in the United States.
Data shows that these diseases, and their negative consequences, disproportionately affect individuals from minority populations, often times by a staggering amount. Individuals from minority populations are more likely to experience more than one chronic condition at a time and often face other barriers, like language and cultural differences, which often make it more challenging for them to receive optimal care.
According to Dr. Elena Rios, President and CEO of the National Hispanic Medical Association, “By the time we turn sixty-five just about everyone has a disease or condition. For many people, especially individuals from minority populations, many chronic diseases hit people all at once.”
Many programs seek to improve the health of individuals from minority populations; Medicare Advantage (MA) is one program that is making strides in care coordination as a means of connecting and improving care for individuals from minority populations with multiple chronic conditions. In fact, according to a recent AHIP analysis, Medicare Advantage is a vital source of coverage for low- income beneficiaries and racial/ethnic populations. In 2012, the program had higher enrollment among minority populations overall compared to traditional Medicare (30 percent versus 23 percent).
Medicare Advantage has also demonstrated success at providing improved case management for patients with diabetes – particularly meaningful, given that about 40 percent of individuals from minority populations (including Hispanics, African Americans, Asians/Pacific Islanders, and American Indian and Alaskan natives) suffer from diabetes. In a recent Health Affairs study, Medicare Advantage performance of eye tests for individuals with diabetes was found to be 17 percent higher than traditional Medicare. These tests are critical to preventing vision loss among diabetics – an all too often complication from the disease.
Care coordination activities central to Medicare Advantage plans include the deliberate organizing of patient care activities and sharing information among all of the participants concerned with a patient’s care to achieve safer and more effective care, as well as the providing of support tools like nurse help hotlines, care plans and disease-state education.
“Communication is one of the key components of coordinated care,” said Dr. Ho Luong Tran, President and CEO of the National Council of Asian Pacific Islander Physicians. “Communication includes understanding different cultures, and how to negotiate and communicate with a patient from that perspective.”
More than half of the minority Medicare population has hypertension, with particularly high rates among African Americans. Researchers have found that cholesterol screening rates for individuals with cardiovascular disease to be 7 to 9 percent higher in Medicare Advantage plans compared to FFS. Individuals who lower their cholesterol are less likely to have a heart attach or die from cardiovascular diseases, even if they have already been diagnosed with it.
These are just a few examples of how care coordination is improving the health of individuals from minority populations, but the list goes on and on. The impact of care coordination – with Medicare Advantage bringing about important innovation in this space – on the health of individuals from minority populations is profound and absolutely foundational to eliminating health disparities among America’s seniors.
As the Care for Us Project continues, the Coalition’s MACC Task Force will continue to identify and advance proven care coordination policies and practices that can improve the health and lives of Medicare beneficiaries. You can follow the Task Force via the Coalition for Medicare Choices Twitter feed and blog.