An Equity-Focused Evaluation of a Medicaid-funded Statewide Diabetes Quality Improvement Project Collaborative
OBJECTIVE
Evaluation of the Ohio Diabetes Quality Improvement Project (QIP) equity aim to reduce the percentage of Non-Hispanic Black (NHB) and Hispanic patients with an A1c >9% by 20% over 2 years.
RESEARCH DESIGN AND METHODS
Ohio’s Department of Medicaid, Government Resource Center, Medicaid Managed Care Plans and 7 medical schools formed a Diabetes Quality Improvement Project (QIP) collaborative using the collective impact model to improve diabetes outcomes and equity in 20 practices across 11 health systems. The QI strategies included data audit and feedback, peer-to-peer learning, QI coaching/practice facilitation, and subject matter expert consultation through coaching calls, monthly webinars, and annual virtual learning sessions. Electronic health record data was collected for pre-intervention (2019-2020) and intervention (2020-2022) periods. Improvements in A1c were based on prevalence of A1c >9% from pre-intervention, Year 1 and Year 2 stratified by race and ethnicity.
RESULTS
The Diabetes QIP included 7,689 (54% female) sociodemographically diverse patients, self-identifying as non-Hispanic White (NHW) (42%), NHB (43%), Hispanic (8%), non-Hispanic Asian (4%) and other (3%). In year 2 compared to baseline, there were decreases in the proportion of patients with A1c >9% in NHW, NHB and Hispanic patients (NHW 19% to 12% [37% reduction]; NHB 23% to 18% [22% reduction]; and Hispanic 29% to 23% [20% reduction]).
CONCLUSIONS
The Ohio Diabetes QIP focused on multisector collaborative approaches reduced the percentage of patients with A1c > 9% by 20% in NHW, NHB and Hispanic populations. Given the persistence of disparities, further equity-focused refinements are warranted to address disparities in diabetes control.
