title: Use of geocoding in managed care settings to identify quality disparities.
abstract: Tracking quality-of-care measures is essential for improving care, particularly for vulnerable populations. Although managed care plans routinely track quality measures, few examine whether their performance differs by enrollee race/ethnicity or socioeconomic status (SES), in part because plans do not collect that information. We show that plans can begin examining and targeting potential disparities using indirect measures of enrollee race/ethnicity and SES based on geocoding. Using such measures, we demonstrate disparities within both Medicare+Choice and commercial plans on Health Plan Employer Data and Information Set (HEDIS) measures of diabetes and cardiovascular care, including instances in which race/ethnicity and SES have distinct effects.
authors.affiliation: RAND Health, Santa Monica, California, USA. fremont@rand.org
authors.forename: Allen M
authors.initials: AM
authors.lastname: Fremont
authors.forename: Arlene
authors.initials: A
authors.lastname: Bierman
authors.forename: Steve L
authors.initials: SL
authors.lastname: Wickstrom
authors.forename: Chloe E
authors.initials: CE
authors.lastname: Bird
authors.forename: Mona
authors.initials: M
authors.lastname: Shah
authors.forename: José J
authors.initials: JJ
authors.lastname: Escarce
authors.forename: Thomas
authors.initials: T
authors.lastname: Horstman
authors.forename: Thomas
authors.initials: T
authors.lastname: Rector
mesh_terms: D005006:Ethnicity; D005843:Geography; D006801:Humans; D008329:Managed Care Programs / Q000458:organization & administration* / Q000592:standards; D019984:Quality Indicators, Health Care; D044469:Racial Groups; D012923:Social Class; D012935:Social Justice