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Quality improvement for medicaid members of a commercial health plan: impact on racial/ethnic differences
Michael A Rodríguez1, Rose T Calhoun, Darius Jatulis
1David Geffen School of Medicine at UCLA, 10880 Wilshire Blvd, Suite 1800, Los Angeles, CA 90024-4142, USA. mrodriguez@mednet.ucla.edu
Objective:
To describe one commercial Medicaid Managed Care (MMC) health plan's quality improvement (QI) program that achieved high varicella immunization rates among members of an ethnically diverse population in California.
Design:
Retrospective study using administrative data.
Patients:
Blue Cross of California Medicaid enrolled children who turned two years old during each calendar year of the study.
Intervention:
A specialized immunization strategy was implemented with data collected at three time points, pre-intervention (baseline--1998/1999), two-year followup (2001) and three-year followup (2002).
Main Outcome Measure:
Varicella vaccination coverage after the QI initiative.
Results:
A statistically significant increase in varicella immunization rates for the study population was observed between baseline (49.5%) and three-year follow up (89.4%). Baseline differences in immunization rates by physician type and patient ethnicity were reduced.
Conclusion:
Trends in varicella vaccination coverage among members of this commercial MMC plan are in line with trends in overall vaccination coverage in California, indicating that commercial MMC health plans have the capacity to offer accessible and high quality care to ethnically diverse patients to mediate racial/ethnic differences. More work is needed to explore the impact of quality improvement programs of MMC plans in other areas.
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