Health Equity Data Access Program

Health Equity Data Access Program
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2023 Awardees

The Centers for Medicare & Medicaid Services Office of Minority Health (CMS OMH) is excited to announce this year’s grantees for the Health Equity Data Research Program (HEDAP) grant.

Three recipients have been granted funding to access “seats” in the CMS Virtual Research Data Center (VRDC) to CMS-restricted data for minority health research. Each grantee will receive $90,000 in funding for three years of data access to conduct health services research projects focusing on communities, including racial and ethnic minority groups; people with disabilities; lesbian, gay, bisexual, transgender, and queer (LGBTQ+) individuals; people with limited English proficiency (LEP); people residing in rural areas; and people adversely affected by persistent poverty or inequality.

The 2023 grantees are:

  • The George Washington University, How Does Integrating Community Health Centers into Accountable Care Organizations (ACOs) Address Disparities in Access to Specialty Care Among Medicare Beneficiaries?

    The George Washington University will investigate whether ACOs with one or more Community Health Centers (CHC) can improve care integration, reduce disparities, and reduce overall costs among Medicare enrollees. Researchers and investigators plan to utilize data from the VRDC to answer critical research questions. These questions will focus on whether or not patient characteristics differ if enrollees are not assigned to ACOs; determine how utilization, spending, and care patterns among enrollees seeking care in CHCs differ by assignment to an associated ACO; and how specialty care utilization for enrollees receiving care at CHCs differs for those assigned to ACOs as compared to those who are not.

  • University of Kansas Medical Center Research Institute, Assessing the Relationship of Limited English Proficiency with Frequency of Prenatal Health Care Utilization and Maternal Health Outcomes

    The University of Kansas Medical Center Research Institute will assess the relationship between patients with limited English proficiency (LEP) and the frequency of prenatal health care utilization and maternal health outcomes. Their primary research objective is to analyze CMS data comparing patients with LEP to those who are proficient in English regarding type and frequency of prenatal visits, delivery type, and maternal health outcomes following delivery. In addition, they will explore data regarding differences in rural versus urban settings and Medicaid expansion states versus non-Medicaid expansion states to understand the differences between these patient populations and to inform physicians about the barriers to providing equitable care to pregnant patients with LEP.

  • University of Missouri System, Accessing Health Care Disparities for People with Intellectual and Developmental Disabilities by Race, Ethnicity, Gender, and Geographical Location

    The University of Missouri System will research trends in preventive health care use in Medicaid recipients with intellectual and/or developmental disabilities (IDD) in the most recent 5-year span of data. They plan to analyze these trends by race, ethnicity, gender identity, and geographical location to identify specific preventive services that should be observed and further explore disparities. The research will be centered around preventive health measures, including general health examinations, screenings, and gynecological services. The researchers will also focus on intersectional identity in the IDD community.

To learn more, email HEResearch@cms.hhs.gov.

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.

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01/19/2024 10:43 AM