Health equity report
A once-in-a-century pandemic has exposed nationwide racial inequities in health care.
At Blue Cross, we have a deep commitment to quality, affordable health care and that includes equity. So in 2021, we reviewed 2019 data for more than 1.3 million commercial Massachusetts members (the most recent complete data year). We found racial and ethnic inequities in the quality of care in the majority of measures below. These specific measures were chosen because they are widely used in health care to monitor performance on important dimensions of care and service.
In partnership with the clinicians in our network, we'll use this data to make meaningful change. We're publishing these results, which will be updated at least annually, to hold ourselves accountable. Our goal is eliminating racial disparities in the care our members receive.
Chronic Conditions
| Asian | Black | Hispanic | White | |
|---|---|---|---|---|
| Asthma Medication Ratio % of members with persistent asthma who received appropriate medication to prevent asthma attacks (ages 5 - 64) |
76.20% | 69.70% | 68.60% | 74.70% |
| Comprehensive Diabetes Care - BP control % of adult diabetic members with blood pressure controlled (ages 18-75) |
84.30% | 71.40% | 76.60% | 82.40% |
| Comprehensive Diabetes Care - HbA1c Poor Control % of adult diabetic members with uncontrolled HbA1c (diabetes) (ages 18-75) (lower rates indicate higher quality care) |
17.00% | 25.10% | 26.30% | 19.40% |
| Comprehensive Diabetes Care - HbA1c Testing % of adult diabetic members who had HbA1c (diabetes) testing (ages 18-75) |
94.00% | 92.00% | 92.20% | 92.60% |
| Comprehensive Diabetes Care - Medical Attention for Nephropathy % of adult diabetic members who were screened for kidney disease (ages 18-75) |
91.00% | 89.40% | 88.40% | 90.10% |
| Comprehensive Diabetes Care - Retinal Eye Exam % of adult diabetic members who had eye exams performed (ages 18-75) |
68.60% | 65.40% | 60.60% | 65.90% |
| Controlling High Blood Pressure % of adult hypertensive members who keep their blood pressure controlled (ages 18-85) |
77.90% | 65.70% | 72.70% | 78.80% |
| Medication Management for People With Asthma - 50% % of members with persistent asthma who took appropriate medications at least 50% of the time (ages 5-64) |
54.10% | 54.90% | 63.60% | 70.70% |
| Medication Management for People With Asthma - 75% % of members with persistent asthma who took appropriate medications at least 75% of the time (ages 5-64) |
33.10% | 32.00% | 41.10% | 50.20% |
| 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 (ages 21-75 male, 40-75 female) |
78.80% | 68.40% | 70.80% | 83.10% |
| Statin Therapy for Patients With Cardiovascular Disease - Received Statin % of adult members with cardiovascular disease who received statin therapy (ages 21-75 male, 40-75 female) |
91.50% | 90.50% | 85.50% | 88.20% |
| Statin Therapy for Patients With Diabetes - Adherence 80% % of adult members with diabetes who took their statin medication at least 80% of the time (ages 40-75) |
71.00% | 58.10% | 58.30% | 78.10% |
| Statin Therapy for Patients With Diabetes - Received Statin % of adult members with diabetes who received statin therapy (ages 40-75) |
71.90% | 62.70% | 63.10% | 69.80% |
| Use of Spirometry Testing in the Assessment and Diagnosis of COPD % of adult members who were appropriately tested to confirm new diagnosis of COPD (ages 40+) |
Insufficient Data | Insufficient Data | 48.00% | 40.10% |
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 after filling their initial prescription (ages 18+) |
68.10% | 55.20% | 52.00% | 72.10% |
| Antidepressant Medication Management - Continuation Phase % of adult members who remained on an antidepressant medication for at least 6 months after filling their initial prescription (ages 18+) |
54.70% | 43.70% | 36.70% | 59.30% |
| 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 (ages 13+) |
Insufficient Data | Insufficient Data | 6.10% | 14.80% |
| 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 (ages 13+) |
Insufficient Data | Insufficient Data | 11.10% | 19.30% |
| 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 (ages 6+) |
67.30% | 50.00% | 58.30% | 73.20% |
| 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 (ages 6+) |
84.60% | 60.90% | 70.50% | 80.90% |
| 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 (ages 13+) |
Insufficient Data | Insufficient Data | 43.10% | 46.40% |
| 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 (ages 13+) |
Insufficient Data | Insufficient Data | 63.90% | 66.00% |
| 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 (ages 6+) |
61.80% | Insufficient Data | 43.70% | 62.40% |
| 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 (ages 6+) |
80.00% | Insufficient Data | 72.40% | 81.90% |
| 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 (ages 6-12) |
Insufficient Data | Insufficient Data | 38.30% | 52.60% |
| 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 (ages 13+) |
7.10% | 9.30% | 9.70% | 12.40% |
| 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 (ages 13+) |
31.20% | 41.30% | 35.90% | 38.30% |
| Pharmacotherapy for Opioid Use Disorder % of opioid use disorder treatments with adherence to a program for at least 180 days (ages 16+) |
68.00% | 83.60% | 83.90% | 85.60% |
| Risk of Continued Opioid Use - 15 days % of adult members with at least 15 days of prescription opioids in a 30 day period (ages 18+) (lower rates indicate higher quality care) |
1.90% | 4.10% | 3.60% | 4.30% |
| Risk of Continued Opioid Use - 31 days % of adult members with at least 31 days of prescription opioids in a 62 day period (ages 18+) (lower rates indicate higher quality care) |
0.30% | 0.90% | 0.80% | 1.20% |
| Use of Opioids at High Dosages % of adult members who received high dose prescription opioids for more than 15 days during a year (ages 18+) (lower rates indicate higher quality care) |
Insufficient Data | 3.20% | 3.90% | 5.80% |
| Use of Opioids From Multiple Providers - Multiple Pharmacies % of adult members who received prescription opioids from four or more pharmacies (ages 18+) (lower rates indicate higher quality care) |
3.60% | 5.80% | 1.00% | 3.40% |
| Use of Opioids From Multiple Providers - Multiple Prescribers % of adult members who received prescription opioids from four or more prescribers (ages 18+) (lower rates indicate higher quality care) |
16.40% | 14.90% | 16.30% | 18.30% |
| Use of Opioids From Multiple Providers - Multiple Prescribers and Multiple Pharmacies % of adult members who received prescription opioids from four or more pharmacies and prescribers (ages 18+) (lower rates indicate higher quality care) |
0.00% | 1.70% | 0.00% | 1.70% |
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 (ages 3+) |
91.30% | 89.90% | 91.30% | 93.70% |
| Appropriate Treatment for Upper Respiratory Infection % of upper respiratory infections that did not involve an antibiotic prescription (ages 3 months+) |
92.30% | 92.50% | 92.20% | 89.40% |
| Avoidance of Antibiotic Treatment for Acute Bronchitis/Bronchiolitis % of acute bronchitis/bronchiolitis episodes that did not involve an antibiotic prescription (ages 3 months+) |
74.00% | 71.70% | 59.50% | 64.40% |
| 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 (ages 18-50) |
84.70% | 81.90% | 80.70% | 82.40% |
Prevention
| Asian | Black | Hispanic | White | |
|---|---|---|---|---|
| Adolescent Well-Care Visits % of adolescent members who had at least one comprehensive well-care visit with a PCP or OB/GYN (ages 12-21) |
81.90% | 68.90% | 70.30% | 80.20% |
| Colorectal Cancer Screening % of adult members who had appropriate screening for colorectal cancer (ages 50-75) |
67.00% | 63.80% | 65.40% | 70.80% |
| Well-Child Visits in the First 15 Months of Life % of babies who were seen for the appropriate number of well-visits during their first 15 months |
91.70% | 91.90% | 91.40% | 94.40% |
| Well-Child Visits in the Third, Fourth, Fifth and Sixth Years of Life % of children who had at least one annual well-visit with a PCP (ages 3-6) |
94.10% | 88.20% | 89.10% | 94.00% |
Women's Health
| Asian | Black | Hispanic | White | |
|---|---|---|---|---|
| Breast Cancer Screening % of women who had at least one mammogram within the past 2 years (ages 50-74) |
81.50% | 77.30% | 82.90% | 82.80% |
| Cervical Cancer Screening % of women who were screened for cervical cancer using appropriate guidelines (ages 21-64) |
81.90% | 80.30% | 83.00% | 83.60% |
| Chlamydia Screening in Women % of women who were appropriately tested for chlamydia (ages 16-24) |
77.30% | 82.00% | 76.10% | 75.10% |
| Non-Recommended Cervical Cancer Screening in Adolescent Females % of adolescent females who were screened unnecessarily for cervical cancer (ages 16-20) (lower rates indicate higher quality care) |
0.30% | 0.30% | 1.10% | 0.40% |
| Severe Maternal Morbidity Rate % of childbirths with potentially life-threatening complications (lower rates indicate higher quality care) |
2.00% | 4.10% | 2.20% | 2.20% |
| Severe Maternal Morbidity Rate - Other Than Blood Transfusion % of childbirths with potentially life-threatening complications (other than blood transfusion) (lower rates indicate higher quality care) |
1.20% | 2.80% | 1.00% | 1.20% |
Methodology: The member race and ethnicity data underlying Blue Cross’s analyses were imputed using the RAND Bayesian Improved Surname Geocoding (BISG) method, which is a commonly used approach when self-reported data are incomplete. It is likely that analyses based on imputed data 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 transition from imputed data to member self-reported race and ethnicity data.
If you are a BCBSMA member, you can help improve the accuracy of these data right now, by updating your race, ethnicity, and language preferences here.
“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.
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.”