Health Equity Data Access Program

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Overview

CMS Office of Minority Health (OMH) is supporting three (3) “seats” in the CMS Virtual Research Data Center (VRDC) to assist researchers in gaining access to CMS restricted data for minority health research. Awardees will gain access to CMS data to conduct health services research focusing on, but not limited to, minority populations, including race, ethnicity, language, sexual orientation, gender identity, and disability status. This announcement seeks brief project narratives for specific applied research projects that relate to creative and innovative methods for using CMS data to identify, document, assess, and evaluate health disparities among Medicare and Medicaid beneficiaries.

The project should enhance the capacity of the researcher to understand and utilize CMS data in future research projects. Seat access will be funded for a period of 36 months each.

Results of the Health Equity Data Access Program will provide CMS and its agents, (e.g. Quality Improvement Organizations, Hospital Engagement Networks, etc.) with actionable information on the aforementioned subgroups of beneficiaries. This will allow CMS and its agents to realize gains in efficiency and effectiveness by focusing on the identification and eradication of health disparities in disadvantaged populations.

Additionally, CMS OMH encourages cutting-edge proposals that explore intersectionality. Intersectionality takes into account two or more aspects of a person’s identity including: class, race, sexual orientation, gender identity, rurality, disability status, and/or other social determinants.

Interested parties may view the 20 minute webcast “Using CMS Data for Research on Disparities in Health and Health Care” for a quick introduction to a variety of CMS data sources (fee-for-service claims, post-acute care assessments, surveys, and beneficiary demographics), and types of data. Throughout this video, variables of potential interest to disparities researchers are explored; this includes race and ethnicity, disability status, primary language, and dual eligibility. The webcast concludes a discussion of mechanisms for accessing the data.

CMS is interested in data-driven research that explores, but is not limited to, the relationship between health disparities and

  • Improving the quality of care
  • Increasing access to care
  • Estimating the economic burden/financial costs of disparities
  • Evaluating the effects of health care delivery system and payment model reforms
  • Exploring disparity sensitive conditions or diseases
  • Strengthening population health

For more information, download the Health Equity Data Access Program Postcard (PDF).


Seat Holders

Below are projects that our HEDAP seat holders have completed or propose to carry out using data from CMS.

 

2016 Projects

Disparities in surgical care among racial and ethnic minorities in Medicare Accountable Care Organizations (ACOs)

Details

Institution: Brigham and Women’s Hospital

Principal Investigator: Andrew J. Schoenfeld, MD, MSc

Summary: The study examined the effect of accountable care organizations (ACOs) on access to surgical services among minority patients as well as changes in peri-operative outcomes, including morbidity, mortality, readmission, and hospital length of stay.

Publications from this Project:

  1. Schoenfeld, Andrew J. MD, MSc; Sturgeon, Daniel J. MS; et.al. Disparities in rates of surgical intervention among racial and ethnic minorities in Medicare Accountable Care Organizations. Annals of Surgery, March 2019.
  2. Lipa SA, Sturgeon DJ, et.al. Do Medicare Accountable Care Organizations reduce disparities after spinal fracture? Journal of Surgical Research, 2019.

Medicaid payment reform and disparities in cesarean birth and maternal morbidity

Details

Institution: The University of Minnesota School of Public Health

Principal Investigator: Katy Kozhimannil, PhD

Summary: The study evaluated the effects of the policy change on delivery-related Medicaid payments. This study examined: the effects of the policy change on overall cesarean utilization rates; whether the policy change affected cesarean use and quality differentially across race and ethnicity; and whether the policy change narrowed disparities. The study also measured whether the policy change affected rates of severe maternal morbidity overall and by race and ethnicity.

Publications from this Project:

  1. Cesarean delivery rates and costs of childbirth in a state Medicaid program after implementation of a blended payment policy. Medical Care, 2018.

Accessing mental health care disparities by race and ethnicity, gender, and gender identity

Details

Institution: Center for Multicultural Mental Health Equity Research Lab at Cambridge Health Alliance, and Department of Psychiatry at Harvard Medical School

Principal Investigator: Benjamin Lê Cook, PhD, MPH

Summary: The study assessed differences in ACO participation by enrollees' race and ethnicity, gender (including gender minorities), and mental health status. This study examined: disparities within ACOs by dual eligible status; race and ethnicity; and gender in access, utilization, and quality of mental health care services. It also compared access, utilization, and quality disparities for enrollees in treated within ACOs to those not treated in ACOs (i.e., standard Medicare FFS) by race, ethnicity, and gender (including gender minorities).

Publications from this Project:

  1. Ana M. Progovac, Benjamin Lê Cook, et.al. Identifying gender minority patients’ health and health care needs in administrative claims data. Health Affairs, 2018.
  2. Progovac AM, Mullin BO, Creedon TB, Benjamin Lê Cook, et.al. Trends in mental health care use in Medicare from 2009 to 2014 by gender minority and disability status. LGBT Health, 2019 Aug/Sep.
  3. Progovac AM, Mullin BO, Dunham E, Benjamin Lê Cook, et.al. Disparities in suicidality by gender identity among Medicare beneficiaries. American Journal of Preventive Medicine, 2020 Mar.
  4. Acevedo A, Progovac AM, Mullin B, Caputi TL, McWillliams JM, Cook BL. Impact of the Medicare Shared Savings Program on Utilization of Mental Health and Substance Use Services by Eligibility and Race/Ethnicity. Health Services Research. 2021 Feb.

Medicaid payment policy and disparities in mental healthcare among Medicaid and dual eligible beneficiaries

Details

Institution: Center for Multicultural Mental Health Equity Research Lab at Cambridge Health Alliance, and Department of Psychiatry at Harvard Medical School

Principal Investigator: Vicki Fung PhD

Summary: The proposed study aims to study medical care use, including outpatient visits to PCPs for mental health (MH) and non-MH diagnoses, and visits to specialty MH providers. This study examined: quality of care, including selected quality process measures for specific MH conditions overall and by provider specialty, as well as adverse clinical events, including emergency department visits and hospitalizations.

Publications from this Project:

  1. Vicky Fung, PhD; Mary Price, MA; Andrew A Nierenberg, MD. Assessment of Behavioral Health Services Use Among Low-Income Medicare Beneficiaries After Reductions in Coinsurance Fees. JAMA Network Open. October 2020.

 

Newly Funded HEDAP Projects

Health disparities in vascular access, peritoneal dialysis access, and kidney transplantation

Details

Institution: University of Pennsylvania Perelman School of Medicine

Principal Investigator: Dr. Nwamaka Eneanya, MD, MPH, FASN

Summary: This study aims to investigate the impact of race, ethnicity, language, gender, and age on access to care for renal patients, and how these factors contribute to a patient’s eligibility for peritoneal dialysis and kidney transplantation as well as the timeliness of fistula access placement.

Characterizing disparities in the HIV prevention and care continuum among transgender and cisgender CMS beneficiaries

Details

Institution: Brown University School of Public Health

Principal Investigator: Jaclyn White Hughto, PhD, MPH & Theresa Shireman, PhD

Summary: This study aims to identify disparities between transgender and cisgender CMS enrollees in the prevalence and incidence of HIV infection, and engagement in the HIV prevention and care continuum.

Publications from this Project:

  1. Hughto JMW, Hughes L, Ellison J, Yee K, Alpert A, Babbs G, Downing J, Shireman T. Documenting the Health of Aging and Disabled Transgender and Cisgender Medicare Beneficiaries, 2009-2017. Accepted for oral presentation at the 150th American Public Health Association Conference; November 2022; Boston, MA.

Value-based purchasing and persons with disabilities

Details

Institution: Department of Medicine at Boston Children’s Hospital

Principal Investigator: Alyna Chien, MD, MS

Summary: This study aims to understand the relationship between value-based purchasing interventions and care access, quality, and spending for children and young adults with disabilities, especially during their transition into adulthood.

Page Last Modified:
11/18/2022 03:07 PM