Tuesday, February 1, 2022

DMHC Announces Health Equity and Quality Committee Members, First Meeting

The Department of Managed Health Care (DMHC) has established a Health Equity and Quality Committee to help eliminate health care disparities for Californians in accordance with Assembly Bill (AB) 133 (Committee on Budget, 2021). The Committee will make recommendations for standard health equity and quality measures, including annual benchmark standards for health plans to assess equity and quality in health care delivery.

“Establishing the Health Equity and Quality Committee is the first step toward creating actionable and measured outcomes to hold health plans to a higher standard on equity and quality,” said DMHC Director Mary Watanabe. “I look forward to the Committee’s work and receiving their recommendations. The DMHC will continue to focus on the overall goal of the work of this Committee to reduce inequities and promote the delivery of quality health care.”

The Committee’s first meeting will be held virtually on Thursday, February 24, 2022. The Committee will provide its recommendations to the DMHC Director by September 30, 2022. Following the recommendations and after the DMHC adopts standard health equity and quality measures, health plans will be required to annually report equity and quality data and information to the Department. Starting in 2025, the DMHC will publish a Health Equity and Quality Compliance Report on the data and information reported by health plans.

The Department’s goal was to create a Committee reflective of California’s diverse population by including members who represent and have knowledge of diverse communities, including the racial, cultural, ethnic, sexual orientation, gender, economic, linguistic, age, disability, and geographical diversity of California. The Committee membership is also made up of diverse backgrounds familiar with the state’s health care delivery system, including consumer advocates, health plans, hospitals, providers, health care data experts and state departments.

The Committee members and additional information about meetings can be found on the Health Equity and Quality Committee page of the DMHC’s website. All meetings will be open to the public.

The Committee may consider the following in making recommendations for standard health equity and quality measures:

  • Quality measures, including, but not limited to, Healthcare Effectiveness Data and Information Set (HEDIS) measures and the federal Centers for Medicare and Medicaid Services Child and Adult Core Set measures.
  • Surveys or other measures to assess consumer experience and satisfaction, including alternative approaches that take into account cultural competence, health literacy, exposure to discrimination, and social and cultural connectedness, such as connection to community, identity, traditions, and spirituality.
  • Other child and adult quality or outcome measures that the Committee determines are appropriate, including establishing new measures for patient reported outcomes.
  • Effective ways to measure health outcomes in the absence of quality measures, including both of the following:
    • Demographic data or other data related to race, ethnicity, or socioeconomic variables that are currently collected by health care service plans.
    • Other data sources, including the Health Care Payments Data Program established pursuant to Health and Safety Code Section 127671.1, the health evidence initiative of Covered California for the individual and small group markets, and other statistically valid and reliable sources of data.
  • Approaches to stratifying reporting of results by factors, including, but not limited to, age, sex, geographic region, race, ethnicity, language, sexual orientation, gender identity, and income to the extent health plans or public programs have data on these factors and that the results are statistically valid and reliable.
  • Alternative methods to measure health outcomes that permit sufficient stratification to determine impacts on health equity and quality that are not subject to the methodological limitations of current measurement approaches.
  • Alternative methods to measure physical and behavioral health outcomes, including, but not limited to, measures to assess social and cultural connectedness, such as connection to community, identity, traditions, and spirituality. The Department shall consult with the Office of Health Equity in identifying these alternative methods.
  • Measures of social determinants of health, such as housing security, food insecurity, caregiving, and other nonmedical determinants of health.

 

About DMHC:

The DMHC protects the health care rights of more than 27.7 million Californians and ensures a stable health care delivery system. The DMHC Help Center has assisted approximately 2.5 million Californians to resolve complaints and issues with their health plan. The DMHC Help Center provides assistance in all languages and all services are free. For more information visit www.HealthHelp.ca.gov or call 1-888-466-2219.