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Report: Gap closing but health-care disparities persist

A new report from MN Community Measurement (MNCM) on health-care disparities suggests that progress is being made, but differences persist based on populations.

The Minnesota Department of Human Services co-authored the 10th annual report, which was released this morning.

According to the 2016 Health Care Disparities Report, eight of nine statewide measures improved from 2014 to 2015 for adult and children enrolled in Minnesota Health Care Programs such as Medical Assistance and MinnesotaCare. Five of those eight measures showed "statistically significant" improvements when compared to private or employer-based health insurance.

The improvements were reflected in certain cancer screenings, immunizations, and care for asthma, depression and diabetes, according to the 230-plus page report .

However, the numbers aren't all rosy. They highlight ongoing challenges experienced by Minnesotans who are considered "of lower socioeconomic status and represent a disproportionate number of persons of color, American Indian or Alaskan natives, persons with disabilities, and elderly adults." More than 900,000 Minnesotans meet that designation.


Additionally, the report says those on public health care programs "often experience significant personal challenges that create barriers," such as homelessness, lack of transportation and knowledge gaps, among other things.

"By using Minnesota Health Care Programs enrollment as a proxy for socioeconomic status, this report evaluates health care disparities that exist as a result of socioeconomic status," according to a press release from MN Community Measurement.

More specifically, 10 of the 12 statewide performance rates for patients enrolled in public programs were "significantly lower" than those insured with private or employer-based health insurance. The biggest discrepancies for public programs include: 19 percent less likely to receive colorectal cancer screenings; 16 percent less likely to be screened for breast cancer; 15 percent less likely to receive optimal diabetes care; 12 percent less likely to achieve childhood immunization status; and children ages 5-17 were 12 percent less likely to receive optimal asthma control when compared to those with private health insurance.

"This report highlights that there is still significant room for improvement to reduce health care disparities and close the gaps in care," said Jim Chase, MNCM president.

Despite those gaps, improvements have been recorded since the first such report was issued in 2007. It was the first such report in the nation to include "local level information that was actionable for medical groups and clinics, according to MNCM.

Allison O'Toole, chief executive officer of MNsure, addressed some health care-related thoughts Tuesday with Post Bulletin's editorial board, prior to the release of the MNCM report. She said one of the things she hears anecdotally is that people who pay for insurance through the individual marketplace in MNsure sometimes go without using their insurance because the deductibles are so high, consumers are afraid to use their insurance, especially those who pay a large portion of their premiums without subsidies.

O'Toole said she hoped MNsure enrollees were utilizing the preventative care at their disposal.

"Hopefully, it's not true under (MNsure)," O'Toole said. "Preventative care is free under the ACA."

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