Black, Hispanic and Asian Patients Report Worse Patient Experiences than White Patients in Massachusetts

(February 2023)

MHQP Convening Stakeholders to Explore Drivers of These Disparities and How to Reduce Them

Black, Asian and Hispanic patients report worse experiences than White, non-Hispanic patients in Massachusetts. This is the key finding of an analysis of data collected in MHQP’s annual statewide Patient Experience Survey of commercially-insured patients, which were released today, confirming what an analysis of pre-pandemic data had first indicated.

Respondents to the survey who identified as Black, Hispanic and Asian gave lower ratings (on a scale of 1 to 100, with higher scores being more favorable) than respondents who identified as White on the vast majority of questions. For example:

  • ACCESS: On the question which asks patients if they were able to get an appointment for a check-up or routine care as soon as they needed, Black patients reported scores that were 1.9 points lower than scores reported by White patients, Asian patients reported scores that were 9.4 points lower than White patients, and Hispanic patients reported scores that were 4.6 points lower than reported by non-Hispanic patients.
  • CARE COORDINATION: On the question which asks patients if, during their most recent visit, anyone in the provider’s office asked about medications they were taking, Black patients reported scores that were 5.3 points below White patients, Asian patients reported scores that were 5.6 points lower than scores reported by White patients, and Hispanic patients reported scores that were 4.6 points lower than non-Hispanic patients.
  • TRUST: On the question which asks patients if they completely trust their provider’s decisions about which medical treatments are best for them, Black patients reported scores that were 3.4 points lower than reported by White patients, Asian patients reported scores that were 4.2 points lower than White patients, and Hispanic patients reported scores that were 2.2 points lower than reported by non-Hispanic patients.

MHQP looked specifically at Black, Hispanic, Asian and White patients because these were the groups with a large enough sample size to support the analysis. Racial and ethnic disparities were found in every category of care and across two years of statewide data from before the pandemic and two years during the pandemic.

“These findings are stunning. It is simply undeniable that differences in patient experiences exist across racial and ethnic groups in Massachusetts,” said Barbra Rabson, MHQP’s President and CEO. “The questions we must answer now are: why do these disparities exist and what can we do about them?”

A Statewide Initiative

To help answer these questions, MHQP has launched a multistakeholder initiative to help address these issues. The aim of this initiative is to create a system for measuring health equity that is fair and consistent across the state. This will allow participating organizations to better understand the drivers of disparities, make valid comparisons, and begin to look at ways to address these issues across organizations, not just organization by organization.

“By leveraging the shared measurement system MHQP already has in place, we can identify systemic issues that lead to these disparities and begin to look at best practices to drive improvements across organizations, not just organization by organization,” said Rabson.

MHQP’s current partners for this groundbreaking work are:

  • Blue Cross Blue Shield of Massachusetts (BCBSMA)
  • Mass General Brigham
  • Point32Health (parent company of Harvard Pilgrim Health Care and Tufts Health Plan)
  • Steward Health Care System
  • Tufts Medicine Integrated Network

“These patient experience results are troubling, but unfortunately not surprising. Racial and ethnic disparities in healthcare have been long documented, and we must do better,” said Allison Bryant MD, MPH, Senior Medical Director for Health Equity at Mass General Brigham. “While this topic is difficult to confront, we look forward to working with MHQP to help advance this work.”

“We are proud to partner with MHQP in measuring and improving health care inequities,” said Mark Friedberg, Senior Vice President of Performance Measurement and Improvement at Blue Cross Blue Shield of Massachusetts. “BCBSMA is committed to reducing inequities across all aspects of care, including patient experience.”

“The disparities that patients report is disheartening and shows that all of us in the health care community must increase our efforts to address health inequities and collectively work to eliminate them,” said Cain Hayes, President and CEO of Point32Health. “Health equity is a strategic priority for Point32Health and we remain steadfast in our commitment to improving the quality and equity of care received by all our members.”

“We know that health disparities exist due to systems of oppression that impact people and patients in our communities—including but not limited to racism, sexism, xenophobia and classism,” said Theresa Alphonse, Director of Health Equity at Steward Health Care Network. “Participating in this initiative with MHQP and other stakeholders will assist us in strengthening our internal culture of equity.”

“We are committed to eliminating disparities in care as part of our vision to deliver the most frictionless and equitable healthcare experience in the world,” said Emily Young, President of the Tufts Medicine Integrated Network. “We look forward to continuing our partnership with MHQP and other stakeholders to better understand and eliminate these disparities in the communities we so proudly serve.”

About MHQP’s Statewide Patient Experience Survey

Unlike satisfaction surveys that ask about general perceptions, MHQP’s patient experience survey asks people what actually happened when they or their children needed primary care. First conducted in 2005, the survey asks patients to rate the quality of certain doctor-patient interactions and other aspects of care using a nationally developed standard survey instrument. The survey was fielded in the spring of 2022, sampling commercially-insured patients. Results were collected from 474 adult and pediatric primary care practices across the state, representing over 3,300 primary care providers. The results of the survey can be found at MHQP’s consumer-facing website: https://healthcarecompassma.org.

The following organizations invested resources to support MHQP’s 2022 Patient Experience Survey and sustain statewide transparency of patient experience in Massachusetts: Blue Cross Blue Shield of Massachusetts and Point32Health (Harvard Pilgrim Health Care and Tufts Health Plan). In addition, the following provider organizations added their financial support: Tufts Medicine Integrated Network (Lowell General PHO and New England Quality Care Alliance), Mount Auburn Cambridge IPA, Mass General Brigham, The Pediatric Physicians’ Organization at Children’s Hospital Boston, and Steward Health Care.

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