In Pursuit of Health Equity · • Recommendation is A1c below 7% • Less stringent A1C goals (such as ,8%) may be appropriate for patients with a history of severe hypoglycemia,

In Pursuit of Health EquityA panel discussion

MNCM Annual Seminar 2017

© 2017 MN Community Measurement. All Rights Reserved.

There is variation in quality results by race, ethnicity, language and

country of origin

2016 Health Equity of Care Report, page 10.

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There is variation in quality results by purchaser

2016 Health Care Disparities Report, page 10. 3


Optimal Diabetes Care Improved ResultsType one or two, between 18-75 years old, established relationship with primary care or endocrinologist

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2003 2015

A1C < 8.0 64% 72%

Blood Pressure < 140/90 n/a 84%

Tobacco Free 69% 84%

Daily Aspirin, If required 68% 99%

Proper Statin Use n/a 87%

Optimally Managed All Goals

n/a 46%

A1C < 8.0 Tobacco Free Daily Aspirin2003 2015



Optimal Diabetes Care GapsResults Range by Demographics

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Lowest Highest Gap

Race AmericanIndian

27% Asian 53% 26%

Ethnicity Hispanic 39% Non Hispanic 47% 8%

Language Hmong 36% Vietnamese 65% 29%

Country of Origin

Bosnia 32% India 61% 29%

Insurance Medicaid 34% Medicare 52% 18%

2016 Health Equity of Care Report, page 75-78.


Optimal Vascular Care Statewide Results by RaceAs seen in…


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Optimal Vascular Care Regional Results by Country of OriginAs seen in…

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Adolescent Mental Health and/or Depression ScreeningStatewide Results by Preferred LanguageAs seen in…

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Adolescent Mental Health and/or Depression ScreeningRegional Results by RaceAs seen in…

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In 2014, the ACS and CDC launched

MN was already well prepared

Provider Case Study Webinars

Clinic Recognition

How can we address disparities?

HealthPartners Facebook Ads/Blogs

CRCS Campaign

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CRCSMedia Campaign

Newspaper

Allinahealth.org

In-Person (e.g. faith

communities, barber shops, social hubs)

Radio

Public Access TV

Facebook

IFOBT Home Test Kits

Translated Instructions and FAQs

Personal Phone Outreach to LEP’s,

African Americans and American Indians

Reinforcement from from Care Guides

Culturally-Tailored Messaging from

Clinicians

Disparity Reports to Clinic Managers

Patient-Level Intervention

Community-Level Intervention

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African American & Hispanic Latino

International Medical Graduates

• There are between 250-400 International Medical Graduates living in Minnesota

• Many would like to use their medical training to improve the health of their communities

• Some have expressed a willingness to help the MN Department of Health Sage Scopes program increase colon cancer screening in the insured as well as uninsured populations.

Minnesota Department of Health Pilot

• Immigrant Medical Graduates teach and navigate patients based on common native language or country of origin.

• Initial pilots at o People’s Center Cedar Riverside o Hennepin County Medical Center-

Richfield Clinic

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In Pursuit of Health Equity

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PREVENT CURE IMPROVELIVES

MISSION IN MOTION

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STRATEGIC PLAN PROCESS

DiabetesecosystemDiabetes touchesevery aspect of lifefor individuals andcommunities. Helpingpeople with diabetes isthe central focus of ourmission. We bring peopletogether from every cornerto combat the disease.

Peoplewith

diabetes

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PRIORITIES TO DEFEAT DIABETES

Drive discovery

TYPE 2

Raise voice

Support people

Through research, partnerships and innovation on a global scale, drive discoveries to prevent, manage and ultimately cure diabetes.

Intensify the urgency around the diabetes epidemic, and mobilize bold action through advocacy and engagement.

Provide new, effective resources for individuals and populations living with and at risk of developing diabetes and for the health care professionals serving them, and offer that those resources when, where and how they are needed.

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Support people

Provide new, effective resources for individuals and populations living with and at risk of developing diabetes and for the health care professionals serving them, and offer those resources when, where and how they are needed.

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Standards of Care

Promoting Health and Reducing Disparities in Populations

• This section was renamed and now focuses on improving outcomes and reducing disparities in populations with diabetes.

• Recommendations were added to assess patients’ social context as well as refer to local community resources and provide self-management support.

• Tailoring Treatments to Reduce Disparities includes: Ethnic/Cultural/Sex Differences, Access to Health Care, System-Level Interventions, Food Insecurity, Treatment Options, Homelessness and Language Barriers

diabetes.org/professional

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Standards of Care

diabetes.org/professional

• Recommendation is A1c below 7%• Less stringent A1C goals (such as ,8%) may be

appropriate for patients with a history of severe hypoglycemia, limited life expectancy, advanced microvascular or macrovascular complications, extensive comorbid conditions, or long-standing diabetes in whom the goal is difficult to achieve despite diabetes self-management education, appropriate glucose monitoring, and effective doses of multiple glucose-lowering agents including insulin

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SUPPORT PEOPLE

Professional ServicesKey Initiatives

Diabetes Prevention - Diabetes Prevention Program (DPP)• An evidence-based lifestyle change program which has been demonstrated to delay or

prevent the development of type 2 diabetes among people at high risk• New association-wide initiative in 2017.

Diabetes is Primary• A comprehensive 10-hour CE program for primary care providers focused on improving

clinical care

Education Recognition Program• Recognition of Diabetes Self Management Education Programs that qualify for reimbursement

Diabetes INSIDE• An 18-month QI program that guides health systems through a series of process-improvement

training activities and data-driven educational programs

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Impacting Health

Outcomes

MISSION IN MOTION

Intersections: The Partnering Approach Evidence

Based Programs

ADA Strategy

True, lasting partnerships require mutually adopted strategiesThe Association seeks to develop a joint strategy with partners in order to develop synergy, efficiency and scale to the mission.

The American Diabetes Association, National Health Equity Committee is developing programs and/or adapting current programs to communities.

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SUPPORT PEOPLE

Diabetes CampsPower Up Camps

Living With Type 2 Diabetes

ADA Strategy – To reach those we are not currently reaching, in different ways.

Examples of how ADA is reducing barriers and disparities.

What Can I Eat? Walmart Wellness Days

Here is a video that might better explain what we are doinghttps://youtu.be/zen_GQ3Hp5cBest regards,Clarence

Clippers n’ Curls for the Heart is dedicated to reducing the incidence of heart attack and stroke in African Americans by screening for high blood pressure in Twin Cities barber shops and beauty salons.

https://youtu.be/zen_GQ3Hp5c

Documents

In Pursuit of Health Equity · • Recommendation is A1c below 7% • Less stringent A1C goals (such as ,8%) may be appropriate for patients with a history of severe hypoglycemia,