Use of Geocoding in Managed Care Settings to Identify Quality Disparities

Published in: Health Affairs, v. 24, no. 2, Mar./Apr. 2005, p. 516-529

Posted on RAND.org on January 01, 2005

by Allen Fremont, Arlene S. Bierman, Steven L. Wickstrom, Chloe E. Bird, Mona Shah, Jose J. Escarce, Thomas Horstman, Thomas Rector

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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. The authors 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, the authors 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.

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