Managed care plans have been helping to close the gap in the health care of Black and white people in America by identifying patients who might previously be missing out on necessary management procedures of chronic diseases, according to a study published last week in the New England Journal of Medicine.
In the study lead author, Dr. John Ayanian and his colleagues studied 100,000 Medicare patients who were enrolled in HMOs, called “Medicare Advantage” plans, from 2006 to 2011.
“We were certainly hoping we would see indications of progress in eliminating disparities in the country as a whole,” said Ayanian told NPR. “While it was “disappointing” that disparities persisted, he said, “it’s also heartening to see that … in the West, the disparities had been eliminated, and that was both surprising and encouraging.”
Research conducted in 2008 exposed the causes behind the disparities in life expectancies between the races.
“Black males born in 2008 could expect to live 70.2 years, 6.6 years fewer than Black females (76.8 years)” research from Women’s Health USA showed. “The difference between white males and females was 4.9 years, with life expectancies at birth of 75.7 and 80.6 years, respectively. White females could expect to live 3.8 years longer than Black females. The lower life expectancy among Blacks may be partly accounted for by higher infant mortality rates, as well as higher mortality rates throughout the lifespan Heart disease and diabetes — diseases that can be better managed by controlling blood pressure, cholesterol and blood sugar, the risk factors measured in the study — accounted for 38 percent of the gap in mortality between black and white men, and 54 percent of the gap among women.”
Kaiser Permanente is one of the health firms that has been on board for these management plans.
In 2006, Kaiser adopted a population management program to deal with patients with chronic hypertension. The company changed its drug formula to allow a “combined pill” that includes two drugs, to tackle high blood pressure so that it would be more convenient for patients to manage their medications.
This along with other population-based strategies helped result in a dramatic increase in the health of Kaiser’s patients. In the 2000s, very serious heart attacks fell by 62 percent, and the stroke mortality fell by 42 percent according to Dr. Joseph Young, who leads Northern California Kaiser’s clinical hypertension program.
“We want clinicians to do what Kaiser is doing and take seriously to provide high quality race-blind clinical care,” Dr. Anthony Iton, who leads the Healthy Communities initiative at the California Endowment told NPR. “Kaiser is showing it can be done.” He said the study was “very hopeful.”