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Health equity report

At Blue Cross, we have a deep commitment to quality, affordable health care, and that includes equity. As part of our commitment, each year we gather and publish data for more than 1.4 million of our commercial Massachusetts members, using measures widely leveraged by health plans and clinicians to monitor health care quality. See our 2021 data below.

This data has revealed racial and ethnic inequities in many areas of patient care. In partnership with the clinicians in our network, we’re using our data to make meaningful change and to work toward our shared goal of eliminating racial disparities in the care our members receive. Read Coverage for examples of how we’re partnering with Massachusetts provider organizations to address inequities in health care.

Learn more

Chronic Conditions

Asian Black Hispanic White
Asthma Medication Ratio
% of members with persistent asthma who took appropriate medications (age 5-64)
84.30%* 69.60%* 74.20% 78.00%
Comprehensive Diabetes Care - BP control
% of adult diabetic members with blood pressure controlled (age 18-75)
78.90% 71.70%* 73.20%* 78.30%
Comprehensive Diabetes Care - HbA1c poor control (lower rates indicate higher quality care)
% of adult diabetic members with uncontrolled HbA1c (diabetes) (age 18-75)
21.40%* 27.00%* 31.20%* 24.40%
Comprehensive Diabetes Care - HbA1c testing
% of adult diabetic members who had HbA1c (diabetes) testing (age 18-75)
93.20%* 90.80% 90.30% 91.40%
Comprehensive Diabetes Care - retinal eye exam
% of adult diabetic members who had eye exams performed (age 18-75)
63.70% 62.40% 53.80%* 62.40%
Controlling High Blood Pressure
% of adult hypertensive members who keep their blood pressure controlled (age 18-85)
73.10%* 65.00%* 67.10%* 74.80%
Kidney Health Evaluation for Patients With Diabetes
% of adult diabetic members who received a kidney health evaluation during the measurement year (age 18-85)
66.90%* 65.40%* 67.10%* 61.70%
Statin Therapy for Patients with Cardiovascular Disease - Adherence 80%
% of adult members with cardiovascular disease who took their statin medication at least 80% of the time (age 21-75 male, 40-75 female)
84.30% 67.60%* 73.40%* 84.40%
Statin Therapy for Patients with Cardiovascular Disease - Received Statin
% of adult members with cardiovascular disease who received statin therapy (age 21-75 male, 40-75 female)
91.20% 81.20%* 86.90% 89.60%
Statin Therapy for Patients with Diabetes - Adherence 80%
% of adult members with diabetes who took their statin medication at least 80% of the time (age 40-75)
75.40%* 60.60%* 61.00%* 81.80%
Statin Therapy for Patients with Diabetes - Received Statin
% of adult members with diabetes who received statin therapy (age 40-75)
72.80% 63.40%* 67.50%* 72.30%

Mental Health

Asian Black Hispanic White
Antidepressant Medication Management - Acute Phase
% of adult members who remained on an antidepressant medication for at least 12 weeks (age 18+)
69.30%* 59.30%* 63.40%* 77.50%
Antidepressant Medication Management - Continuation Phase
% of adult members who remained on an antidepressant medication for at least 6 months (age 18+)
53.70%* 42.50%* 44.60%* 62.20%
Follow-Up After Emergency Department Visit for Alcohol and Other Drug Dependence - 30 day
% of members with alcohol or other drug dependence who received follow-up care within 30 days of being in the emergency department (age 13+)
Insufficient Data Insufficient Data 14.00%* 23.40%
Follow-Up After Emergency Department Visit for Alcohol and Other Drug Dependence - 7 day
% of members with alcohol or other drug dependence who received follow-up care within 7 days of being in the emergency department (age 13+)
Insufficient Data Insufficient Data 10.90%* 18.50%
Follow-Up After Emergency Department Visit for Mental Illness - 30 day
% of members diagnosed with mental illness who received follow-up care within 30 days of being in the emergency department (age 6+)
Insufficient Data 71.30%* 87.00% 84.80%
Follow-Up After Emergency Department Visit for Mental Illness - 7 day
% of members diagnosed with mental illness who received follow-up care within 7 days of being in the emergency department (age 6+)
Insufficient Data 61.10%* 78.00% 76.20%
Follow-Up After Hospitalization for Mental Illness - 30 day
% of members hopsitalized for mental illness who received follow-up care within 30 days of being discharged (age 6+)
Insufficient Data Insufficient Data 77.30% 81.80%
Follow-Up After Hospitalization for Mental Illness - 7 day
% of members hopsitalized for mental illness who received follow-up care within 7 days of being discharged (age 6+)
Insufficient Data Insufficient Data 48.40%* 64.50%
Follow-Up Care for Children Prescribed ADHD Medication Initiation Phase
% of children with ADHD who had follow-up care with a provider within 30 days of being prescribed their first ADHD medication (age 6-12)
Insufficient Data Insufficient Data 48.20% 50.80%
Initiation and Engagement of Alcohol and Other Drug Dependence Treatment - Engagement
% of members newly diagnosed with alcohol or other drug dependence who had two or more additional services within 34 days (age 13+)
8.80%* 11.50% 10.80% 13.40%
Initiation and Engagement of Alcohol and Other Drug Dependence Treatment - Initiation
% of members newly diagnosed with alcohol or other drug dependence who started treatment within 14 days (age 13+)
32.50% 42.80% 34.90% 38.00%
Risk of Continued Opioid Use - 15 days (lower rates indicate higher quality care)
% of adult members with at least 15 days of prescription opioids in a 30 day period (age 18+)
2.10%* 4.00% 3.30%* 4.70%
Risk of Continued Opioid Use - 31 days (lower rates indicate higher quality care)
% of adult members with at least 31 days of prescription opioids in a 62 day period (age 18+)
0.50%* 1.00% 0.90%* 1.40%
Use of Opioids at High Dosage (lower rates indicate higher quality care)
% of adult members who received high dose prescription opioids for more than 15 days during a year (age 18+)
Insufficient Data 4.20% 5.30% 6.20%
Use of Opioids from Multiple Providers - Multiple Pharmacies (lower rates indicate higher quality care)
% of adult members who received prescription opioids from four or more pharmacies (age 18+)
0.10%* 2.20% 1.20% 1.30%
Use of Opioids from Multiple Providers - Multiple Prescribers (lower rates indicate higher quality care)
% of adult members who received prescription opioids from four or more prescribers (age 18+)
20.40% 14.60% 12.30%* 17.10%
Use of Opioids from Multiple Providers - Multiple Prescribers and Multiple Pharmacies (lower rates indicate higher quality care)
% of adult members who received prescription opioids from four or more pharmacies and prescribers (age 18+)
0.00%* 3.30% 1.20% 0.90%

Other Testing and Treatment

Asian Black Hispanic White
Appropriate Testing for Pharyngitis
% of incidents of pharyngitis (sore throat) that resulted in completion of appropriate testing (age 3+)
72.00%* 69.30%* 72.60%* 82.70%
Appropriate Treatment for Upper Respiratory Infection
% of upper respiratory infections that did not involve an antibiotic prescription (age 3 months+)
98.00%* 95.20% 95.30% 95.40%
Avoidance of Antibiotic Treatment for Acute Bronchitis/Bronchiolitis
% of acute bronchitis/bronchiolitis episodes that did not involve an antibiotic prescription (age 3 months+)
Insufficient Data Insufficient Data 65.60% 65.30%
Use of Imaging Studies for Low Back Pain
% of adult members diagnosed with low back pain who avoided unnecessary X-rays, CT scans or MRIs (age 18-50)
82.80% 81.60% 80.20% 81.50%

Prevention

Asian Black Hispanic White
Child and Adolescent Well-Care Visits
% of child and adolescent members who had at least one comprehensive well-care visit with a PCP or OB/GYN (age 3-21)
82.20% 70.10%* 70.30%* 81.90%
Colorectal Cancer Screening
% of adult members who had appropriate screening for colorectal cancer (age 50-75)
60.60%* 58.50%* 60.80%* 68.30%
Well-Child Visits for Age 15 Months-30 Months
% of children who had at least two well-visit with a PCP (age 30 months)
94.90% 88.60%* 90.90%* 95.70%
Well-Child Visits in the First 15 Months
% of babies who had at least six well-visit with a PCP (age 15 months)
92.60% 89.70%* 84.50%* 94.90%

Women's Health

Asian Black Hispanic White
Breast Cancer Screening
% of women who had at least one mammogram within the past 2 years (age 50-74)
74.50%* 74.90%* 78.00%* 79.80%
Cervical Cancer Screening
% of women who were screened for cervical cancer using appropriate guidelines (age 21-64)
77.40%* 78.00%* 79.90% 80.70%
Chlamydia Screening in Women
% of women who were appropriately tested for chlamydia (age 16-24)
73.10%* 77.10%* 71.30% 69.60%
Non-Recommended Cervical Cancer Screening in Adolescent Females (lower rates indicate higher quality care)
% of adolescent females who were screened unnecessarily for cervical cancer (age 16-20)
0.10%* 0.00%* 0.40% 0.30%
Prenatal Immunization Status - E - Combination
% of women who had the recommended vaccinations prior to childbirth
50.90%* 34.30%* 41.90% 44.70%
Severe Maternal Morbidity Rate (lower rates indicate higher quality care)
% of childbirths with potentially life-threatening complications
3.10% 6.50%* 2.80% 2.90%
Severe Maternal Morbidity Rate - Other Than Blood Transfusion (lower rates indicate higher quality care)
% of childbirths with potentially life-threatening complications (other than blood transfusion)
1.50% 4.40%* 1.00% 1.40%

MHQP Patient Engagement Survey - Adult

Asian Black Hispanic White
Getting Quality Care from Staff in the Doctor's Office
The MHQP Patient Experience Survey is a statewide survey of commercially insured patients in Massachusetts. More information about the MHQP survey can be found at https://www.mhqp.org/learn-about-the-survey/
91.20%* 95.20% 92.50%* 94.40%
Getting Timely Appointments, Care, and Information
The MHQP Patient Experience Survey is a statewide survey of commercially insured patients in Massachusetts. More information about the MHQP survey can be found at https://www.mhqp.org/learn-about-the-survey/
73.50%* 80.60% 79.20%* 83.10%
How Well Doctors Communicate with Patients
The MHQP Patient Experience Survey is a statewide survey of commercially insured patients in Massachusetts. More information about the MHQP survey can be found at https://www.mhqp.org/learn-about-the-survey/
95.00%* 94.70%* 95.80% 96.30%
How Well Doctors Coordinate Care
The MHQP Patient Experience Survey is a statewide survey of commercially insured patients in Massachusetts. More information about the MHQP survey can be found at https://www.mhqp.org/learn-about-the-survey/
86.10%* 87.50% 83.20%* 89.30%
How Well Doctors Know Their Patients
The MHQP Patient Experience Survey is a statewide survey of commercially insured patients in Massachusetts. More information about the MHQP survey can be found at https://www.mhqp.org/learn-about-the-survey/
88.90%* 89.90%* 90.50% 91.30%
How Well Doctors Pay Attention to Mental (Behavioral) Health
The MHQP Patient Experience Survey is a statewide survey of commercially insured patients in Massachusetts. More information about the MHQP survey can be found at https://www.mhqp.org/learn-about-the-survey/
62.10%* 61.80%* 66.30%* 71.90%
How Well Doctors Support Patient Self-Management
The MHQP Patient Experience Survey is a statewide survey of commercially insured patients in Massachusetts. More information about the MHQP survey can be found at https://www.mhqp.org/learn-about-the-survey/
53.20%* 64.60% 62.50% 63.20%
Patients' Willingness to Recommend Their Provider to Family and Friends
The MHQP Patient Experience Survey is a statewide survey of commercially insured patients in Massachusetts. More information about the MHQP survey can be found at https://www.mhqp.org/learn-about-the-survey/
88.70%* 90.50% 90.10%* 92.10%

MHQP Patient Engagement Survey - Pediatrics

Asian Black Hispanic White
Getting Quality Care from Staff in the Doctor's Office
The MHQP Patient Experience Survey is a statewide survey of commercially insured patients in Massachusetts. More information about the MHQP survey can be found at https://www.mhqp.org/learn-about-the-survey/
93.20%* 92.30%* 94.80% 96.10%
Getting Timely Appointments, Care, and Information
The MHQP Patient Experience Survey is a statewide survey of commercially insured patients in Massachusetts. More information about the MHQP survey can be found at https://www.mhqp.org/learn-about-the-survey/
81.80%* 91.60% 90.10% 89.80%
How Well Doctors Communicate with Patients
The MHQP Patient Experience Survey is a statewide survey of commercially insured patients in Massachusetts. More information about the MHQP survey can be found at https://www.mhqp.org/learn-about-the-survey/
97.40% 98.10% 97.90% 98.30%
How Well Doctors Coordinate Care
The MHQP Patient Experience Survey is a statewide survey of commercially insured patients in Massachusetts. More information about the MHQP survey can be found at https://www.mhqp.org/learn-about-the-survey/
82.00% 90.60% 85.80% 86.50%
How Well Doctors Give Advice About Keeping Your Child Safe and Healthy
The MHQP Patient Experience Survey is a statewide survey of commercially insured patients in Massachusetts. More information about the MHQP survey can be found at https://www.mhqp.org/learn-about-the-survey/
63.70% 57.80% 62.70% 65.10%
How Well Doctors Know Their Patients
The MHQP Patient Experience Survey is a statewide survey of commercially insured patients in Massachusetts. More information about the MHQP survey can be found at https://www.mhqp.org/learn-about-the-survey/
90.90%* 92.80% 94.40% 93.80%
How Well Doctors Pay Attention to Your Child's Growth and Development
The MHQP Patient Experience Survey is a statewide survey of commercially insured patients in Massachusetts. More information about the MHQP survey can be found at https://www.mhqp.org/learn-about-the-survey/
72.10% 62.40%* 70.60%* 75.10%
How Well Doctors Support Patient Self-Management
The MHQP Patient Experience Survey is a statewide survey of commercially insured patients in Massachusetts. More information about the MHQP survey can be found at https://www.mhqp.org/learn-about-the-survey/
46.90% 50.00% 49.40% 48.60%
Patients' Willingness to Recommend Their Provider to Family and Friends
The MHQP Patient Experience Survey is a statewide survey of commercially insured patients in Massachusetts. More information about the MHQP survey can be found at https://www.mhqp.org/learn-about-the-survey/
92.60%* 94.40% 95.40% 96.10%

If you’re a Blue Cross Blue Shield of Massachusetts member, you can help improve the accuracy of these data right now, by updating your race, ethnicity, and language preferences here.

Race/ethnicity data: The 2021 member race and ethnicity data underlying Blue Cross’ analyses (race/ethnicity data version 3) were a mix of self-reported data (approximately 17% of Blue Cross Blue Shield of Massachusetts members included in this report) and imputed data, which is a commonly used approach when self-reported data are incomplete. Imputed race and ethnicity were derived using a multinomial logistic regression model that combines data from the RAND Bayesian Improved First Name, Surname, and Geocoding (BIFSG) method, the Massachusetts Immunization Information System (MIIS), and other member-level information. More information about the RAND BIFSG method can be requested from: https://www.rand.org/health-care/tools-methods/bisg.html. More information about the MIIS data can be requested from: https://www.mass.gov/massachusetts-immunization-information-system-miis.

Analyses that include imputed data might overestimate or underestimate the true magnitude of inequities (i.e., the magnitude of inequities that would be calculated if 100% self-reported race and ethnicity data were available).** For this reason, Blue Cross is currently engaged in a major effort to collect self-reported race and ethnicity data from members directly. Future versions of these analyses will incorporate more member self-reported race and ethnicity data as it becomes available.

We have assessed the accuracy of the imputed data in race/ethnicity data version 3 by comparing these data to the values reported by in-state members who have shared their self-reported race and ethnicity with Blue Cross. For members self-identifying as Asian, we found that the imputed data have sensitivity: 95.1%, specificity: 99.1%, positive predictive value (PPV): 90.9%, negative predictive value (NPV): 99.5%. Among members self-identifying as Black, the imputed data have sensitivity: 81.2%, specificity: 99.5%, PPV: 83.1%, NPV: 99.4%. For members self-identifying as Hispanic, the imputed data have sensitivity: 74.8%, specificity: 99.4%, PPV: 87.7%, NPV: 98.5%. Among White non-Hispanic members, the imputed data have sensitivity: 99.1%, specificity: 81.9%, PPV: 95.3%, NPV: 96.1%. We currently lack sufficient self-reported data to assess the accuracy of imputed data for members who self-identify as American Indian/Alaska Native, Native Hawaiian/Other Pacific Islander, Other, and Multiracial. To generate the accuracy calculations reported in this paragraph, we categorized the output probabilities from the imputation regression model described above using a plurality rule (i.e., assigning the category with the highest probability). However, in the measure-by-measure health equity report above, the output probabilities from the imputation regression model were used directly.

*Indicates when the inequity between minoritized racial and ethnic group (Asian, Black, Hispanic) members and White members is statistically significant (p < 0.05).

“Insufficient Data” indicates that there were fewer than 90 members of the indicated race and ethnicity who were included in the measure denominator (i.e., who had a condition or health event that caused the measure to apply to them).

Learn more about the corresponding NCQA measures.

The measure specification for Controlling High Blood Pressure is now based on the HEDIS definition that was first implemented for measurement year 2020.

The Severe Maternal Morbidity rate among delivery hospitalizations is based on the CDC measure specification.

The MHQP Patient Experience Survey is a statewide survey of commercially insured patients in Massachusetts. This survey asked patients about experiences with their providers or their children’s providers, and other staff in the providers’ office. The survey also asked members for their self-reported race and ethnicity, with >95% response rates to these survey items among members who returned the survey. To assess care delivered in 2021, MHQP collected survey data in the spring of 2022 from over 31,000 patients statewide, including nearly 20,000 Blue Cross members. The Patient Experience Survey data displayed above reflect care delivered to these nearly 20,000 Blue Cross members, using self-reported race and ethnicity data (and no imputed data) given the high response rate to the race and ethnicity survey items. More information about the MHQP survey can be found at: https://www.mhqp.org/learn-about-the-survey/.

**This report is based on Blue Cross’ race/ethnicity data version 3, as described above. To access earlier versions of these race/ethnicity data and earlier performance years, you can download these files:

  • Our 2019 equity report based on race/ethnicity data version 1 (as published in September 2021) here
  • Our 2019 equity report based on race/ethnicity data version 2 (as published in October 2022) here
  • Our 2019 equity report based on race/ethnicity data version 3 here
  • Our 2020 equity report based on race/ethnicity data version 2 (as published in October 2022) here, and
  • Our 2020 equity report based on race/ethnicity data version 3 here

 

Note: The logic used to produce these HEDIS measure results has not been certified by NCQA. Such results are for reference only and are not an indication of measure validity. A calculated measure result (a “rate”) from a HEDIS measure that has not been certified via NCQA’s Measure Certification Program, and is based on unadjusted HEDIS specifications, may not be called a “Health Plan HEDIS rate” until it is audited and designated reportable by an NCQA-Certified HEDIS Compliance Auditor. Until such time, such measure rates shall be designated or referred to as “Uncertified, Unaudited Health Plan HEDIS Rates.”