Quality assurance key to health care discussion


Health care reform will expand health care coverage to thousands of Minnesotans, and with coverage they will have access to necessary services. But will such access ensure fair and equitable health care?

A new report from MN Community Measurement, “2009 Health Care Disparities Report for Minnesota Health Care Programs,” takes a closer look at whether best practices are achieved for patients participating in Minnesota Health Care Programs (MHCP), which includes Medical Assistance, MinnesotaCare and General Assistance Medical Care.

The report looked at 10 measures selected by the Minnesota Department of Human Services:

  • Optimal diabetes care

  • Controlling high blood pressure

  • Use of appropriate medication for asthma

  • Appropriate treatment of children with upper respiratory infection

  • Appropriate testing of children with pharyngitis

  • Breast cancer screening

  • Cervical cancer screening

  • Colorectal cancer screening

  • Chlamydia screening

  • Childhood immunization status

For all measures still comparable (all, but chlamydia screening), performance rates have improved for patients on Minnesota Health Care Programs (MHCP) over multiple years, and compared to just last year’s report, seven measures show improvement.

However, when comparing MHCP patients with patients on other insurance, i.e. private, eight of the measures show that health care best practices are achieved significantly less often for patients on MHCP. But that gap has narrowed over the past four to six years for most measures.

The largest gap between MHCP patients and others were for colorectal cancer screening and breast cancer screening. And for two measures, the gap between MHCP patients and others have widened in the last three and six years for controlling high blood pressure and optimal diabetes care, respectively.

At the medical group level, there were differences for all measures when comparing MHCP patients and others. Even the medical groups whose achievement was higher than average with MHCP patients still performed better with other patient groups.

As the media rightfully points out, the fight over health care is far from over, but rather than get too caught up in the possible repeals and lawsuits, we should start thinking about the next step — ensuring equitable and fair, high quality health care for all.