Researchers Develop Health Equity Data Dashboard for Medicare Plans

Research recently published in The American Journal of Managed Care describes the design and evaluation of a dashboard that presents health equity performance data to Medicare Advantage (MA) contracting organizations to drive quality improvements.

The researchers noted that the Office of the Assistant Secretary for Planning and Evaluation recommends that the Centers for Medicare & Medicaid Services (CMS) include measures to encourage a focus on health equity and related quality improvement efforts in quality reporting, but barriers to presenting actionable information on health equity hamper this process.

To combat this, the research team sought to create a quality dashboard to positively impact care quality and patient safety. The dashboard is designed to present summarized and more in-depth details of the health equity measurement known as the Health Equity Summary Score (HESS), which was developed to provide MA contracting organizations with information about their performance in terms of clinical care and patient experience for underserved groups.

The HESS is focused on two groups identified by the National Academy of Medicine as living with greater social risk-related obstacles to health and high-quality care and for whom sufficient data are available within Medicare data systems: individuals who belong to racial and ethnic minority groups, and individuals with low-income status, characterized as those who are dually eligible for Medicare and Medicaid or who receive a Medicare low-income subsidy (LIS).

The researchers noted that “advancing health equity involves identifying health plans that do better or worse at providing high-quality care to individuals disproportionately burdened by social risks to health,” so the dashboard was designed to make data from the HESS more relevant and comprehensible to health plans in various ways, such as providing additional contextual information and points of comparison to help users better evaluate their scores.

The online version of the dashboard was created after determining the interpretability and usability of the dashboard information for quality improvement staff at MA organizations using a paper-based version of the tool, interviews, and listening sessions. It includes five sections: Introduction and Summary of Your Performance, Explanation of the HESS, Your Data on the HESS for Clinical Care, Your Data on the HESS for Patient Experience, and a fifth, unnamed section describing data sources and underlying analyses.

Following dashboard creation, the researchers conducted usability tests to evaluate the dashboard’s ease of navigation and the clarity of its information. Eight tests were undertaken with participants not affiliated with MA organizations but familiar with healthcare quality measurement and reporting.

Users were tasked with exploring the dashboard as if they were quality improvement managers at a health plan trying to understand the HESS and their organization’s performance, after which an interviewer asked questions and directed them to different parts of the website to gauge understanding, navigability, and perceived usefulness of the data.

Overall, all participants found the data potentially valuable and well presented, but seven out of eight stated that site navigation could be improved. Participants also suggested that the dashboard provide more context to help with interpreting scores, which led the research team to add a pop-up feature highlighting the percentage of contracts that scored higher and lower than the focal contract on the HESS component.

The increased focus on health equity necessitates tools that allow health plans to better serve their populations, and the dashboard created in this study is one such potential tool, the researchers concluded. They also indicated that the dashboard could serve as a model for plan leaders to build similar tools and advance health equity.