Applications of Indirect Estimation of Race/Ethnicity Data

Anthem Blue Cross (California)

In order for a health plan to address racial and ethnic disparities, it must first identify the disparities - and before it can do that, the Plan must determine the race and ethnicity of its members. Historically, Anthem Blue Cross (California) did not collect this information, so in 2006 its parent company, WellPoint, Inc., engaged the RAND Corporation to develop methodologies to estimate member race and ethnicity using a combination of name analyses and addresses geocoded with census data.

WellPoint, Inc. further refined these methodologies in 2007, producing a relatively accurate picture of its membership. These data estimates, together with GIS mapping tools, allowed Anthem Blue Cross to identify hotspots of unscreened members, study provider access for minority members, identify minority members for culturally and linguistically appropriate health screening reminders and health education materials, and determine member threshold language needs to meet regulatory requirements. With these results, Anthem Blue Cross could examine differences among racial and ethnic groups for various health indicators, such as diabetes and colorectal and mammography screening rates, and take action to address disparities in these areas.

This indirect estimation model proved to be a cost-effective tool that could be applied to a wide range of projects. In fact, it was so successful that it is being used in a quality-improvement initiative across all 14 Blue plans owned by WellPoint, Inc. With the availability of race and ethnicity data on members — even if it is compiled indirectly, as in this program, and not from the patients themselves — health plans can design targeted and culturally sensitive quality improvement interventions. Such programs have the potential to have a greater impact on the health of their members than the traditional one-size-fits-all programs and, thus, can help reduce disparities in healthcare.

Program contact:  Grace H. Ting, Health Services Director, 805.557.4075, grace.ting@wellpoint.com