2019 Health Disparities Report - California

2019 Health Disparities Report

Managed Care Quality and Monitoring Division

California Department of Health Care Services

December 2020

Property of the California Department of Health Care Services

2019 Health Disparities Report

Table of Contents

Commonly Used Abbreviations and Acronyms ..................................................................v

1. Executive Summary.........................................................................................................1

Background.........................................................................................................................1

Medi-Cal Managed Care Program and Health Disparities .................................................2

Key Findings for Racial/Ethnic Health Disparities...............................................................5

American Indian or Alaska Native .................................................................................5

Asian ...............................................................................................................................6

Black or African American .............................................................................................6

Hispanic or Latino ..........................................................................................................6

Native Hawaiian or Other Pacific Islander ....................................................................7

Other ...............................................................................................................................7

Overall Conclusions and Items for Consideration...............................................................8

2. Reader¡¯s Guide ...............................................................................................................11

Introduction .......................................................................................................................11

Medi-Cal Managed Care Health Plans .............................................................................11

Summary of Performance Indicators ................................................................................12

Methodology Overview .....................................................................................................13

Data Sources................................................................................................................14

Statistical Analysis .......................................................................................................14

Evaluating Results ............................................................................................................15

Figure Interpretation.....................................................................................................15

Choropleth Map Interpretation.....................................................................................17

Cautions and Limitations...................................................................................................18

Limiting Members .........................................................................................................18

Health Disparities Results ...........................................................................................18

COVID-19 Impacts on Reporting ................................................................................18

Electronic Health Record Data ....................................................................................19

3. Findings ...........................................................................................................................20

Racial/Ethnic Health Disparities........................................................................................20

Antidepressant Medication Management¡ªEffective Acute Phase Treatment

(AMM¨CAcute) .............................................................................................................20

Antidepressant Medication Management¡ªEffective Continuation Phase Treatment

(AMM¨CCont) .................................................................................................................22

Asthma Medication Ratio¡ªTotal (AMR¨CTot) .............................................................24

Breast Cancer Screening (BCS) .................................................................................26

Chlamydia Screening in Women¡ªTotal (CHL¨CTot) ..................................................28

Contraceptive Care¡ªAll Women¡ªMost or Moderately Effective Contraception¡ª

Ages 15¨C20 Years (CCW¨CMMEC¨C1520) ...................................................................29

Contraceptive Care¡ªAll Women¡ªMost or Moderately Effective Contraception¡ª

Ages 21¨C44 Years (CCW¨CMMEC¨C2144) ...................................................................31

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TABLE OF CONTENTS

Contraceptive Care¡ªPostpartum Women¡ªMost or Moderately Effective

Contraception¡ª60 Days¡ªAges 21¨C44 Years (CCP¨CMMEC60¨C2144) ...................32

Developmental Screening in the First Three Years of Life¡ªTotal (DEV¨CTot) .........34

Plan All-Cause Readmissions¡ªObserved Readmission Rate¡ª

Total (PCR¨COR¨CTot) ...................................................................................................36

4. Geographic Variability by County for Select Indicators ..........................................37

Appendix A. Demographic Stratification Results.........................................................A-1

Appendix B. Methodology ................................................................................................B-1

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TABLE OF CONTENTS

Table of Figures

Figure 1.1¡ªOverall Racial/Ethnic Health Disparities for All Indicators ................................5

Figure 2.1¡ªSample Indicator-Level Horizontal Bar Graph Figure .....................................16

Figure 2.3¡ªSample Horizontal Stacked Bar Graph

by Demographic Stratification Figure ...............................................................17

Figure 3.1¡ªAntidepressant Medication Management¡ªEffective Acute Phase

Treatment (AMM¨CAcute) Rates by Race/Ethnicity ...........................................21

Figure 3.2¡ªAntidepressant Medication Management¡ªEffective Continuation Phase

Treatment (AMM¨CCont) Rates by Race/Ethnicity .............................................22

Figure 3.3¡ªAsthma Medication Ratio¡ªTotal (AMR¨CTot) Rates by Race/Ethnicity .........24

Figure 3.4¡ªBreast Cancer Screening (BCS) Rates by Race/Ethnicity .............................26

Figure 3.5¡ªChlamydia Screening in Women¡ªTotal (CHL¨CTot) Rates

by Race/Ethnicity ...............................................................................................28

Figure 3.6¡ªContraceptive Care¡ªAll Women¡ªMost or Moderately Effective

Contraception¡ªAges 15¨C20 Years (CCW¨CMMEC¨C1520) Rates by

Race/Ethnicity .....................................................................................................29

Figure 3.7¡ªContraceptive Care¡ªAll Women¡ªMost or Moderately Effective

Contraception¡ªAges 21¨C44 Years (CCW¨CMMEC¨C2144) Rates by

Race/Ethnicity .....................................................................................................31

Figure 3.8¡ªContraceptive Care¡ªPostpartum Women¡ªMost or Moderately Effective

Contraception¡ª60 Days¡ªAges 21¨C44 Years (CCP¨CMMEC60¨C2144)

Rates by Race/Ethnicity .....................................................................................32

Figure 3.9¡ªDevelopmental Screening in the First Three Years of Life¡ª

Total (DEV¨CTot) Rates by Race/Ethnicity .........................................................34

Figure 3.10¡ªPlan All-Cause Readmissions¡ªObserved Readmission Rate¡ª

Total (PCR¨COR¨CTot) Rates by Race/Ethnicity .................................................36

Figure 4.1¡ªCalifornia Map by County .................................................................................37

Figure 4.2¡ª Antidepressant Medication Management¡ªEffective Acute Phase

Treatment (AMM¨CAcute) Geographic Variability by County ...........................38

Figure 4.3¡ªAntidepressant Medication Management¡ªEffective Continuation Phase

Treatment (AMM¨CCont) Geographic Variability by County ..............................39

Figure 4.4¡ªAsthma Medication Ratio¡ªTotal (AMR¨CTot) Geographic Variability

by County ............................................................................................................40

Figure 4.5¡ªBreast Cancer Screening (BCS) Geographic Variability by County ...............41

Figure 4.6¡ªChlamydia Screening in Women¡ªTotal (CHL¨CTot) Geographic

Variability by County ..........................................................................................42

Figure A.1¡ªAntidepressant Medication Management¡ªEffective Acute Phase

Treatment (AMM¨CAcute) Rates by Primary Language ................................. A-1

Figure A.2¡ªAntidepressant Medication Management¡ªEffective Continuation Phase

Treatment (AMM¨CCont) Rates by Primary Language .................................... A-2

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Figure A.3¡ªAsthma Medication Ratio¡ªTotal (AMR¨CTot) Rates

by Primary Language .......................................................................................A-3

Figure A.4¡ªBreast Cancer Screening (BCS) Rates by Primary Language .................... A-4

Figure A.5¡ªChlamydia Screening in Women¡ªTotal (CHL¨CTot) Rates

by Primary Language .......................................................................................A-5

Figure A.6¡ªContraceptive Care¡ªAll Women¡ªMost or Moderately Effective

Contraception¡ªAges 15¨C20 Years (CCW¨CMMEC¨C1520) Rates

by Primary Language .......................................................................................A-6

Figure A.7¡ªContraceptive Care¡ªAll Women¡ªMost or Moderately Effective

Contraception¡ªAges 21¨C44 Years (CCW¨CMMEC¨C2144) Rates

by Primary Language .......................................................................................A-7

Figure A.8¡ªContraceptive Care¡ªPostpartum Women¡ªMost or Moderately Effective

Contraception¡ª60 Days¡ªAges 21¨C44 Years (CCP¨CMMEC60¨C2144)

Rates by Primary Language ............................................................................A-8

Figure A.9¡ªDevelopmental Screening in the First Three Years of Life¡ªTotal (DEV)

Rates by Primary Language ............................................................................A-9

Figure A.10¡ªPlan All-Cause Readmissions¡ªObserved Readmission Rate¡ªTotal

(PCR¨COR¨CTot) Rates by Primary Language................................................ A-10

Table of Tables

Table 1.1¡ªMCAS Indicators...................................................................................................3

Table 2.1¡ªMCPs and Applicable Counties .........................................................................11

Table 2.2¡ªMCAS Indicators.................................................................................................13

Table 2.3¡ªStatewide Performance Quintile Thresholds and Corresponding Colors........18

Table B.1¡ªDemographic Stratification Groups ................................................................. B-5

Table B.2¡ªRacial/Ethnic Stratification Groups ................................................................. B-6

Table B.3¡ªIndicators and Age Groups..............................................................................B-6

Table B.4¡ªStatewide Performance Quintile Thresholds and Corresponding Colors ..... B-9

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