In the first external analysis of the California Department of Health Service's Medi-Cal Managed Care program, researchers from the UCLA Department of Family Medicine found widespread health care disparities based on ethnicity, race and language throughout the system.
And African Americans are bearing the brunt of it.
These disparities can lead to a lower quality of care for the state's minority populations, resulting in poorer health for these groups, as well as higher health care and social costs. The UCLA researchers make a series of recommendations aimed at correcting these disparities.
The study findings were presented March 27 during a health policy briefing in Sacramento aimed at informing legislative staff and academics about the challenges facing Medi-Cal. The University of California's California Program on Access to Care, which funded the study, sponsored the briefing.
"Medicaid is the largest provider of health care services to low-income ethnic minority populations in our nation," said Dr. Michael Rodriguez, associate professor of family medicine at the David Geffen School of Medicine at UCLA and co-director of the Network for Multicultural Research on Health and Healthcare. "Therefore, it is in Medicaid's best interest to reduce health care disparities in order to promote good health, reduce preventable medical complications and reduce health care costs."
The researchers examined 2006 data from eight health plans that contract with California's Medi-Cal Managed Care Division (MMCD) Blue Cross of California, Central Coast Alliance for Health, Contra Costa Health Plan, Health Net, Inland Empire Health Plan, Kern Health Systems, LA Care and San Francisco Health Plan. The eight plans together serve about 70 percent of MMCD beneficiaries.
Among MMCD enrollees, 55.2 percent are Hispanic, 16.6 percent are non-Hispanic white, 13.1 percent are black/African-American and 11.7 percent are Asian/Pacific Islander. Primary languages spoken among enrollees are English, Spanish, Southeast Asian languages such as Cambodian and Thai, and others, such as Farsi, Polish and American Sign Language.
Researchers analyzed 16 care areas within three broad categories: child and adolescent health care, women's health care, and chronic and other diseases. They found that quality of care was significantly lower in 10 of 16 areas for African Americans, compared with other groups. Additionally, care quality was lower for non-Hispanic whites in 3 of 16 measures, and most surprisingly English speakers received lower quality of care than non-English speakers in 13 of 16 measures, possibly due in part to efforts by MMCD to improve services for those with limited English-language skills.
Specific findings included the following:
Among the researchers' policy recommendations are:
|Contact: Enrique Rivero|
University of California - Los Angeles