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A Program to reduce the disparity in the rate of biennial lipid profiles between african-american and white medicare beneficiaries with diabetes mellitus in new york city

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Abstract

The burden of diabetes is more severe for minority populations than for the white population in the United States. Analysis of Medicare fee-for-service claims data revealed a significant disparity regarding screening for lipids between white and African-American Medicare beneficiaries with diabetes as measured by the biennial lipid profile indicator in New York State and the disparity was even greater in New York City. Thus IPRO, the Medicare New York State Quality Improvement Organization, launched a multifaceted quality improvement project to reduce the disparity, targeting African-American Medicare beneficiaries with diabetes in New York City and the providers who serve them. There was an absolute increase of 16.7% in the proportion of African-American beneficiaries with diabetes receiving a biennial lipid profile in the intervention areas and the disparity reduced by 9.8% between African-American and all eligible white beneficiaries in the intervention areas. Although it was not feasible to determine the direct impact of selected interventions on reducing the disparity, the interventions collectively appeared to be effective.

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Acknowledgments

The authors wish to thank Shelia McCullugh, Martha Carney, Michele Jones, Deborah Johnson-Ingram, Raymond Han, and Thomas Huang, all of IPRO, who carried out the practice interventions and computer programming support for this study. In addition, the authors thank Dr. Pascal James Imperato for his insightful comments on earlier versions of this paper. The analyses on which this publication is based were performed under Contract 500-02-NY-01 entitled “Utilization and Quality Control Peer Review Organization for the State of New York,” sponsored by the Centers for Medicare and Medicaid Services (CMS), Department of Health and Human Services. The content of this publication does not necessarily reflect the views or policies of the Department of Health and Human Services, nor does mention of trade names, commercial products, or organizations imply endorsement by the U.S. Government.

The authors assume full responsibility for the accuracy and completeness of the ideas presented. This article is a direct result of the Health Care Quality Improvement Program initiated by the Centers for Medicare and Medicaid Services, which has encouraged identification of quality improvement projects derived from analysis of patterns of care, and therefore requires no special funding on the part of this contractor. Ideas and contributions to the authors concerning experience in engaging with issues presented are welcomed.

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Authors and Affiliations

  1. IPRO, 1979 Marcus Avenue, Lake Success, NY, 11042, USA

    Terry Mahotière MD, MPH, Katja Ocepek-Welikson MPhil, Maryanne B. Daley RN, BSN & Johan P. Byssainthe MPH

Authors
  1. Terry Mahotière MD, MPH
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  2. Katja Ocepek-Welikson MPhil
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  3. Maryanne B. Daley RN, BSN
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  4. Johan P. Byssainthe MPH
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Corresponding author

Correspondence to Terry Mahotière MD, MPH.

Additional information

Terry Mahotière, MD, MPH is a medical officer at IPRO; Katja Ocepek-Welikson, MPhil, is a project manager/analyst at IPRO, Maryanne B. Daley, RN, BSN, is a project manager at IPRO; Johan P. Byssainthe, MPH is a performance improvement coordinator at IPRO.

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Mahotière, T., Ocepek-Welikson, K., Daley, M.B. et al. A Program to reduce the disparity in the rate of biennial lipid profiles between african-american and white medicare beneficiaries with diabetes mellitus in new york city. J Community Health 31, 263–288 (2006). https://doi.org/10.1007/s10900-006-9015-7

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  • DOI: https://doi.org/10.1007/s10900-006-9015-7

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