Study Shows Preventive Care Initiative Effective in Combatting Health Care Inequities
Comptroller Natalie Braswell released a detailed health equity analysis of the state employee health plan on Monday, the first of its kind, and a series of corresponding recommendations to reduce racial and gender disparities across the state.
Braswell and Governor Ned Lamont emphasized the importance of preventive care in combatting racial inequities in health care, citing the state’s successful Health Enhancement Program (HEP) which is credited with reducing racial and ethnic disparities in cancer screening and chronic disease management.
“By prioritizing preventive care, and removing barriers between patients and their doctors, the state plan is effectively fighting back against racial disparities that commonly plague the health care system,” said Comptroller Natalie Braswell. “Since HEP was implemented, my office has heard from many members who were able to detect cancer early and now credit the program with saving their lives. Everyone in Connecticut deserves access to similar programs, regardless of where they work or live.”
“Life-saving preventive care needs to be easily accessible for everyone in our state,” said Governor Ned Lamont. “Regular screenings can detect disease in the early stages, protecting patients from catastrophic health and financial outcomes. Our administration has prioritized expanding access to these services to counter racial inequality and improve public health. I’ll continue to work directly with all parts of our health care sector to ensure every Connecticut resident can access and afford the care they need.”
This past year’s budget adjustment (Public Act 22-118) includes a provision introduced by the governor’s administration to require health carriers to offer versions of HEP to their enrolled members. Those plans must be available by Jan. 1, 2024.
The health equity analysis compares medical and prescription drug claims in the state employee health plan to a benchmark of nearly 100 other health plans, including multi-employer and public sector plans, covering nearly two million members. Utilization data was used to measure racial and gender disparities in several key areas.
The state plan significantly outperformed the benchmark across all racial groups for the screening of breast, prostate, colorectal and cervical cancers. Nearly all racial groups also exceeded the benchmark for chronic disease management, including regular testing and adherence to medications. This is owed largely to the plan’s preventive care initiatives which incentivize members to receive recommended age-based screenings.
Notable disparities were detected in emergency room visits. Black and Hispanic members were more likely to seek emergency care, and less likely to receive preventive visits. The same is true for members at lower income levels and in geographic areas where provider access is limited. Non-White plan participants also had a higher prevalence of diabetes.
The analysis was performed by Segal, an independent actuarial firm, and in consultation with Health Equity Solutions (HES), who collaborated in the design of the study and its recommendations.
“HES commends the State Employee Health Plan’s commitment to health equity and willingness to build on its efforts to ensure its enrollees all have the opportunity to avoid preventable illness and injury,” said Ayesha Clarke, Interim Executive Director of Health Equity Solutions. “Health inequalities persist at all income levels, and this study shows that state employees are no exception. What is exceptional is the commitment of the Office of the State Comptroller to evaluating and addressing these inequities, particularly for Black, Latino/a, and other people of color enrolled in the state employee health plan. We are pleased to see the report released to the public and look forward to learning how the recommendations for improving data collection and access to preventive health care will be implemented.”
Among the report’s recommendations is for the state health plan to survey members to pinpoint the causes of continuing disparities, expand member communications and continue to work directly with doctors, hospitals and provider groups to eliminate barriers to care.
More broadly, the recommendations include a statewide expansion of preventive care by offering a version of the state’s successful Health Enhancement Program (HEP) to more residents. Increased access to affordable high-speed internet is recommended to combat telehealth disparities, particularly in low-income communities.
“This analysis shows many areas where the state health plan is effectively combatting persistent health care disparities, particularly in cancer screenings and the treatment of chronic conditions,” said Comptroller Braswell. “It also shows areas where there is room for improvement, and many recommendations that the state health plan, and other health plans across the state, can implement to further address racial and gender disparities throughout the health care system. It’s our shared responsibility to make health care affordable and accessible for everyone in Connecticut. Every health care organization should engage in this kind of review to identify its own strengths and weaknesses, and then act. We need more data, across the board, to better diagnose the causes of disparities and continue to craft effective solutions.”
Comptroller Braswell administers the State of Connecticut Health Plan, the largest employer-based plan in the state, covering over 250,000 state and municipal workers, retirees and their dependents. The analysis uses data from the state employee health plan, the largest and most robust dataset.
The report can be viewed on the comptroller’s website, here: osc.ct.gov/reports
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