Joining forces to reduce disparities: Lessons learned from the National Health Plan Collaborative

Developing strategies to reduce health disparities among patient and member populations has been a strategic goal at HealthPartners since 2002, when we formed a cross cultural care and service taskforce to lay the foundation for reducing health disparities.

In 2003, the task force conducted an organization-wide assessment of cultural competence to determine a baseline of organizational capabilities. Key subgroups of employees, including HealthPartners and Regions Hospital Boards of Directors, strategic leaders, employees and health professionals received surveys. The goal was to identify opportunities for improvement and develop a multi-year plan to improve cross cultural care and services and reduce health disparities. In 2004, the Task Force developed a multi-year plan with strategies in the areas of education, language access and data collection for measuring disparities. The task force also chartered work groups in: data collection and information, interpreter services, staff education and leadership development.  

In 2004, the interpreter services workgroup developed a language assistance plan for spoken and sign language services. The plan formalized best practices in interpreter services for the organization and included a companion user guide. Additionally, HealthPartners clinics and Regions Hospital began collecting race/ethnicity and language preference data, self reported by patients, through its electronic medical record. HealthPartners Clinics began reporting on data collection rates and patient satisfaction by race and ethnicity in 2004 and began reporting on selected quality measures by race in 2006.

Also in 2006, HealthPartners health plan began collecting race/ethnicity and language preference data, self reported by members, through its case management division and through a secure member page on healthpartners.com.

HealthPartners clinics serve more than 425,000 patients in the Twin Cities metropolitain area. HealthPartners Clinics is the only large clinic system in Minnesota collecting cultural and linguistic data and making interventions to reduce disparities based on data. In 2004, HealthPartners clinics began collecting race/ethnicity data, self reported by patients, through its electronic medical record. Data collection has been very successful. HealthPartners Clinics now has language data on 100% of its patient population and race data on more than 70% of its patient population.

In 2005, HealthPartners clinics conducted an analysis of select quality metrics and patient satisfaction by race. The analysis showed disparities in some key quality metrics, so the group formed an equitable care expert panel to increase the number of patients from culturally diverse populations that receive all evidence-based recommended clinical services for preventive care and chronic disease management. 

The goal of the equitable care expert panel was to identify the contributing causes of observed clinical quality and patient satisfaction disparities through a comprehensive review of our process capabilities, our patient population preferences and engagement in their health care, and input from community members and representatives of diverse cultural and racial populations. Identifying contributing causes helped to shape development of interventions to reduce disparities. 

The scope of work for this project included the development of interventions aimed at improving the percentage of the non-white patient population that received evidence-based recommended care, including preventive services, diabetes care, and child and teen check-up (C&TC). The panel chose these areas because they disproportionately affect minorities more than whites.

HealthPartners believes that other health care organizations can replicate, in whole or in part, the strategies it has implemented to identify and reduce health disparities. The keys to success include:

• Leadership and staff commitment to reducing health disparities ·       
• The ability to measure and report on health care quality.
• Staff willingness to collect data and consistent workflows that ensure appropriate staff members are asking for information in a respectful way at the most appropriate time.
• Well-planned operational designs that leverage an electronic medical record in collecting data
• Measuring and reporting collection rates for race/ethnicity and language preference data