Reducing Racial Disparities in Health Outcomes Through a Publicly Financed Insurance Expansion
Expanding Health Care Coverage
March 20, 2008
Racial and ethnic minorities in New York are disproportionately uninsured and suffer worse health outcomes than whites. Approximately 22% of black adults, 31% of Latino adults and 22% of Asian/Pacific Islander adults are uninsured, compared with 13% of white adults, according to data from the 2007 Current Population Survey as reported by the Community Service Society of New York (CSSNY). To address this issue, CSSNY provided policymakers with proposals and recommendations to reduce racial disparities in health care access and outcomes for New Yorkers enrolled in public insurance programs.
This project was part of a larger NYHealth Coverage Consortium that funded 10 grants to seven universities, policy institutes, and community agencies across the State, supporting projects that could inform State health reform efforts, offer ways to streamline enrollment in public programs, significantly reduce costs and improve quality, and test ideas for expanding coverage among small employers, sole proprietors, and self-employed people.
Read an NYHealth special report that contains a summary of findings from this consortium.
Lack of insurance coverage is one of the most significant determinants of disparities in health care outcomes among African American and Latino populations. Under this grant, the Community Service Society will develop a health reform proposal that reduces racial and ethnic disparities in health care access and outcomes for New Yorkers enrolled in public insurance programs, with a particular focus on managed care enrollees.
The need for coordinated, statewide efforts to reduce racial and ethnic health care disparities in New York State is clear. A higher percentage of African Americans, Latinos, and Asian/Pacific Islanders are uninsured, compared to whites. Hispanic African-Americans have the highest age-adjusted mortality rates from a variety of illnesses, while Hispanic-Americans have the highest asthma prevalence rates and are more likely than any other racial or ethnic group to experience premature death. As Medicaid is the largest provider of health insurance for minority populations in the U.S.–covering at least one in five non-elderly Hispanics and African Americans compared to one in 10 Whites–quality improvement efforts implemented through Medicaid and other public programs are a logical starting point for interventions to eliminate disparities in health care outcomes for racial and ethnic minorities.
The Community Service Society will undertake two projects to address racial and ethnic disparities in health insurance coverage. On a national level, it will review and assess current racial disparities initiatives that could be applied to a State reform initiative. It will also examine current regional and/or statewide efforts to address racial and ethnic disparities in health care access, delivery, or outcomes, and document their key features and outcomes. It will primarily focus on enrollees in Medicaid Managed Care, Family Health Plus, and Child Health Plus plans, and will examine public programs’ and managed care plans’ data collection procedures. The Community Service Society also will conduct an assessment of available data on racial disparities in New York, and use these findings to develop a proposal that seeks to reduce racial disparities in health care access and outcomes for New Yorkers enrolled in public insurance programs, with a particular focus on managed care enrollees. Proposal features will include: 1) a description of potential statewide benchmarks of care and a process to gain consensus around such benchmarks; 2) a discussion of data collection procedures for both New York State Department of Health and managed care plans that participate in the public programs; and 3) recommendations regarding use of financial incentives to reduce racial and ethnic disparities in health care.
This project is part of the NYHealth Coverage Consortium.