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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 1.2 million of our commercial Massachusetts members, using measures widely leveraged by health plans and clinicians to monitor health care quality. See our 2020 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)
86.60%* 72.80% 74.60% 78.10%
Comprehensive Diabetes Care - BP control
% of adult diabetic members with blood pressure controlled (age 18-75)
85.10% 74.10%* 80.10%* 84.50%
Comprehensive Diabetes Care - HbA1c poor control (lower rates indicate higher quality care)
% of adult diabetic members with uncontrolled HbA1c (diabetes) (age 18-75)
15.50%* 23.60%* 26.30%* 17.40%
Comprehensive Diabetes Care - HbA1c testing
% of adult diabetic members who had HbA1c (diabetes) testing (age 18-75)
87.40% 83.50%* 84.20%* 87.00%
Comprehensive Diabetes Care - retinal eye exam
% of adult diabetic members who had eye exams performed (age 18-75)
58.40% 57.60% 54.60%* 59.50%
Controlling High Blood Pressure
% of adult hypertensive members who keep their blood pressure controlled (age 18-85)
79.10% 68.70%* 74.80%* 80.10%
Kidney Health Evaluation for Patients With Diabetes
% of adult diabetic members who received a kidney health evaluation during the measurement year (age 18-85)
61.10%* 59.40%* 59.40%* 56.30%
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)
84.70% 70.70%* 77.30% 84.90%
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)
92.00% 84.70% 84.50% 88.80%
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)
76.10%* 62.90%* 63.50%* 81.90%
Statin Therapy for Patients With Diabetes - Received Statin
% of adult members with diabetes who received statin therapy (age 40-75)
71.00% 65.10%* 65.00%* 71.30%
Use of Spirometry Testing in the Assessment and Diagnosis of COPD
% of adult members who were appropriately tested to confirm new diagnosis of COPD (age 40+)
Insufficient Data 23.40% 30.60% 37.80%

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+)
63.50%* 56.40%* 56.50%* 74.30%
Antidepressant Medication Management - Continuation Phase
% of adult members who remained on an antidepressant medication for at least 6 months (age 18+)
49.10%* 38.30%* 38.90%* 59.20%
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 10.10% 17.10% 26.00%
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 8.40% 11.00% 21.60%
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+)
72.80% 58.70% 73.10% 83.00%
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+)
67.70% 53.00% 64.30% 75.00%
Follow-Up After High-Intensity Care for Substance Use Disorder - 30 day
% of substance use disorder treatment episodes that were followed up with care within 30 days (age 13+)
Insufficient Data Insufficient Data 49.40% 43.80%
Follow-Up After High-Intensity Care for Substance Use Disorder - 7 day
% of substance use disorder treatment episodes that were followed up with care within 7 days of initial treatment (age 13+)
Insufficient Data Insufficient Data 31.60% 23.70%
Follow-Up After Hospitalization for Mental Illness - 30 day
% of members hospitalized for mental illness who received follow-up care within 30 days of being discharged (age 6+)
79.10% 71.40% 70.80% 82.60%
Follow-Up After Hospitalization for Mental Illness - 7 day
% of members hospitalized for mental illness who received follow-up care within 7 days of being discharged (age 6+)
66.90% 48.00% 54.50% 65.40%
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)
45.50% 52.30% 45.10% 51.30%
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+)
7.40%* 10.60% 10.90% 13.90%
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+)
30.60%* 37.80% 34.80% 38.50%
Pharmacotherapy for Opioid Use Disorder
% of opioid use disorder treatments with adherence to a program for at least 180 days (age 16+)
Insufficient Data Insufficient Data Insufficient Data 34.50%
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+)
2.00%* 4.60% 3.30%* 5.00%
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+)
0.30%* 1.70% 0.40%* 1.50%
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+)
0.40% 4.50% 5.10% 5.90%
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+)
5.10% 2.90% 0.60%* 2.00%
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+)
21.20% 18.40% 15.20% 17.70%
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+)
5.20% 2.00% 0.50% 1.00%

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+)
88.20% 84.80% 80.50%* 88.50%
Appropriate Treatment for Upper Respiratory Infection
% of upper respiratory infections that did not involve an antibiotic prescription (age 3 months+)
95.70%* 96.60%* 94.00%* 90.00%
Avoidance of Antibiotic Treatment for Acute Bronchitis/Bronchiolitis
% of acute bronchitis/bronchiolitis episodes that did not involve an antibiotic prescription (age 3 months+)
73.60%* 81.10%* 61.90% 65.10%
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)
83.00% 87.60%* 84.40% 83.80%

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)
80.20%* 62.60%* 67.30%* 81.40%
Colorectal Cancer Screening
% of adult members who had appropriate screening for colorectal cancer (age 50-75)
62.10%* 57.80%* 61.30%* 68.30%
Well-Child Visits for Age 15 Months-30 Months
% of children who had at least two well-child visits with a PCP (age 30 months)
95.00% 88.30%* 93.20%* 96.60%
Well-Child Visits in the First 15 Months
% of babies who had at least six well-child visits with a PCP (age 15 months)
91.10%* 89.40%* 90.80%* 94.30%

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)
76.60%* 71.80%* 78.30%* 79.90%
Cervical Cancer Screening
% of women who were screened for cervical cancer using appropriate guidelines (age 21-64)
77.60%* 75.30%* 79.60%* 81.00%
Chlamydia Screening in Women
% of women who were appropriately tested for chlamydia (age 16-24)
66.30% 72.40%* 69.90%* 66.60%
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)
0.00%* 0.20% 0.40% 0.40%
Severe Maternal Morbidity Rate (lower rates indicate higher quality care)
% of childbirths with potentially life-threatening complications
1.90%* 7.80%* 4.10% 2.70%
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)
1.10% 5.20%* 1.90% 1.30%

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.

Methodology: The 2020 member race and ethnicity data underlying Blue Cross’ analyses were a mix of self-reported data (approximately 13% of Blue Cross Blue Shield of Massachusetts members included in this report) and imputed data using the RAND Bayesian Improved First Name, Surname, and Geocoding (BIFSG) method, which is a commonly used approach when self-reported data are incomplete. More information about the RAND BIFSG method can be requested from RAND. Analyses based on imputed data might overestimate or underestimate the true magnitude of inequities. 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 they become available. Previous analyses also are available. Download 2019 report as published in September 2021, which uses imputed race and ethnicity data using the RAND Bayesian Improved Surname Geocoding method. Download an updated version of the 2019 report, which uses more accurate race and ethnicity data: self-reported race and ethnicity data when available, supplemented by imputed data using the updated RAND Bayesian Improved First Name Surname Geocoding method.

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

Due to the COVID-19 pandemic, for its provider incentive contracts Blue Cross Blue Shield of Massachusetts modified the specifications of three outcomes measures (Controlling High Blood Pressure, Comprehensive Diabetes Care - BP control, and Comprehensive Diabetes Care - HbA1c poor control) so that blood pressure and HbA1c values that were at goal in 2019 were carried forward into 2020 whenever no 2020 values were checked. This one-time 2020-only measure modification resulted in slightly better scores on these measures in 2020 than in 2019.

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.”