title: Population Care Management and Team-Based Approach to Reduce Racial Disparities among African Americans/Blacks with Hypertension.
abstract: OBJECTIVE
  At Kaiser Permanente, national Equitable Care Health Outcomes (ECHO) Reports with a baseline measurement of 16 Healthcare Effectiveness Data and Information Set measures stratified by race and ethnicity showed a disparity of 8.1 percentage points in blood pressure (BP) control rates between African- American/black (black) and white members. The aims of this study were to describe a population care management team-based approach to improve BP control for large populations and to explain how a culturally tailored, patient-centered approach can address this racial disparity.
  
  
  METHODS
  These strategies were implemented through: 1) physician-led educational programs on treatment intensification, medication adherence, and consistent use of clinical practice guidelines; 2) building strong care teams by defining individual roles and responsibilities in hypertension management; 3) redesign of the care delivery system to expand access; and 4) programs on culturally tailored communication tools and self-management.
  
  
  RESULTS
  At a physician practice level where 65% of patients with hypertension were black, BP control rates (< 140/90 mmHg) for blacks improved from 76.6% to 81.4%, and control rates for whites increased from 82.9% to 84.2%. The racial gap narrowed from 6.3% to 2.8%. As these successful practices continue to spread throughout the program, the health disparity gap in BP control has decreased by 50%, from 8.1% to 3.9%.
  
  
  CONCLUSIONS
  A sustainable program to collect self-reported race, ethnicity, and language preference data integrated with successful population care management programs provided the foundation for addressing health disparities. Cultural tailoring of a multilevel team-based approach closed the gap for blacks with hypertension.
authors.affiliation: National Program Leader for Kaiser Permanente National Quality and Equitable Care in Oakland, CA. rowena.e.bartolome@kp.org.
authors.forename: Rowena E
authors.initials: RE
authors.lastname: Bartolome
authors.affiliation: Physician in Charge at the Gardena Medical Office in CA. agnes.e.chen@kp.org.
authors.forename: Agnes
authors.initials: A
authors.lastname: Chen
authors.affiliation: Expert Panel Member of the Eighth Joint National Committee on High Blood Pressure; Hypertension Clinical Lead, Care Management Institute; and is the Hypertension Lead for Southern California Kaiser Permanente in Anaheim, CA. joel.handler@kp.org.
authors.forename: Joel
authors.initials: J
authors.lastname: Handler
authors.affiliation: Principal Consultant for Hospitals, Quality and Care Delivery Excellence in Oakland, CA. sharon.platt@kp.org.
authors.forename: Sharon Takeda
authors.initials: ST
authors.lastname: Platt
authors.affiliation: Senior Director for Quality, Hospital Oversight andEquitable Care for Kaiser Foundation Health Plan and Hospitals in Oakland, CA. berny.gould@kp.org.
authors.forename: Bernice
authors.initials: B
authors.lastname: Gould
mesh_terms: D001741:Black or African American; D003695:Delivery of Health Care; D054625:Healthcare Disparities; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D055118:Medication Adherence; D010348:Patient Care Team; D016730:Program Development; D057566:Self Report
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