Office of Health Equity
JudyAnn Bigby, M.D.
Secretary
Executive Office of Health and Human Services
Presentation Overview
•	Health Disparities Council Framework

•	Diabetes as a Disease State Case Study

•	 Application of Framework

Quality Improvement in Diabetes Care

Diabetes as a Disparities 
Disease State Case Study
Expected Outcomes
•	Improve quality of diabetes care for racial and ethnic minority groups
•	Decrease diabetes related morbidity and mortality
•	Decrease disparities in prevalence of diabetes through prevention and early detection
•	Break the cycle of increasing obesity among blacks and Latinos by making communities healthier

Current Initiatives
•	Patient Centered Medical Homes Initiative
•	Masshealth Pay-for-Performance
•	Race and Ethnicity Data Collection Efforts
•	DPH Community Grant Program
•	HealthyMass Diabetes Task Force

Improving Access to and Quality of Care (1)
•	Patient Centered Medical Homes Initiative
•	Diabetes as clinical focus
•	MassHealth dominant practices
•	Improve disease management for populations served
•	MassHealth Pay-for-Performance
•	Performance payments made to hospitals and providers based on presences of infrastructure to track and address disparities
•	Report disparities; address disparities
•	Race and Ethnicity Data Collection Efforts
•	Stratification of Data by Race and Ethnicity
Diabetes Task Force: Goals
•	Integration of public health and medical care
•	Early detection and chronic disease management using chronic care model
•	Decrease hospitalizations and readmissions
•	Decrease complications
Diabetes Task Force
•	Help providers adhere to the Massachusetts Guidelines for Adult Diabetes Care for patients with diabetes and pre-diabetes.
•	Implement systems changes that will facilitate a coordinated, multidisciplinary team approach to care.
•	Increase the number of patients with diabetes who receive diabetes self-management education (DSME) and medical nutrition therapy (MNT) in accordance with state guidelines.
•	Ensure that appropriate staffing levels, training programs and certification resources exist to provide the full range of services needed for patients with diabetes and pre-diabetes.
Individual Factors: Personal Behaviors (2)
•	Mass in Motion
•	Promote healthy behaviors related to eating and physical activity
•	Focus on culturally appropriate materials
•	Community based initiatives
•	Diabetes Task Force 
•	Develop TV, radio and print campaign with diabetes-specific message to reach a broad audience - Diabetes can affect anyone.   The task Force recommends a focus on the “Many Faces of Diabetes.”
•	Create a healthy workplace environment for preventing and managing diabetes resulting in measurable and improved outcomes for adults living with diabetes.
•	Develop a high-level statewide public awareness and education campaign targeting high risk groups
•	Increase the number of patients with diabetes who receive diabetes self-management education (DSME) and medical nutrition therapy (MNT) in accordance with state guidelines.

Institutional Transformation (3)
•	Partner with Health Plans to identify best practices
•	Massachusetts Guidelines for Adult Diabetes Care implementation and best practices to outcome and performance measurement (1,2, 3 and 5)
•	MassHealth P4P
•	Performance measures reward reporting and decreasing disparities
•	HCQCC
•	Performance measurement alignment
•	Inform work to align measurements related to disparities
Community Factors (4)
•	Diabetes Task Force
•	Expand the Working on Wellness Initiative to additional employers across the state. 
•	Develop TV, radio and print campaign with diabetes-specific message to reach a very broad audience - Diabetes can affect anyone.   The task Force recommends a focus on the “Many Faces of Diabetes.”
•	Improving access to affordable healthy foods in communities
•	Promoting physical activity
•	Transportation compact
•	DPH wellness grants to communities
Sociopolitical/Policy Factors (5)
•	Transportation Bill
•	Requires community health impact assessment
•	Promotes policies to promote physical activity as transportation initiatives are developed in all communities.
Discussion 
•	Gaps
•	Recommendations from Council
•	Framework applied to other disease states
•	Infant mortality
•	Asthma
•	Other