Most health plans are missing key socioeconomic data required to develop meaningful population health management programs for vulnerable patients.

Source: Thinkstock

 By Jennifer Bresnick

March 07, 2017 - Managed care policymakers do not have access to enough clean, complete, and accurate socioeconomic and population health data on the millions of patients depending on public insurance programs for care, according to a new article in Health Affairs.

“To reduce disparities, it is critical to first know where they exist,” said the research team from CMS and NCQA.  “Improving documentation of race, ethnicity, and language needs in managed care plan reporting, regardless of data collection method, and clarifying how high-performing health plans achieve their results, will be important.”

Plans collect this data, among other information, through the Healthcare Effectiveness Data and Information Set (HEDIS).  Yet the majority of insurers are missing critical data on huge swathes of the patient population.

Health plans are particularly deficient in collecting information on race, ethnicity, and patient language needs, with commercial entities being among the worst offenders. 

Between 2012 and 2015, more than 80 percent of commercial plans were missing at least half of their HEDIS data about ethnicity, primary spoken language, and primary written language for their beneficiaries.

READ MORE: Identifying Care Disparities for Population Health Management