UP - Disparities Receipt of Guideline-Compliant Care (C2570)

We propose to quantify disparities in the receipt of guideline-compliant care (GCC) among the Kentucky Medicaid enrollees with diabetes and examine how GCC affects diabetes outcomes. We will focus on five preventive care recommendations (A1c test, foot exam, eye exam, urinary microalbuminuria testing, and statin use) in the American Diabetes Association clinical guidelines and major macro- and microvascular complications and hospital encounters as outcomes. Our overarching hypotheses are: 1) there are significant disparities in the receipt of GCC by race/ethnicity, primary care service areas, managed care organizations (MCOs), and traditional vs. expansion groups, and 2) these disparities significantly affect diabetes-related outcomes and healthcare costs. We will use Kentucky state Medicaid data from 2011 – 2019 (latest year with complete data) linked to county and ZIP code level data available from the Health Resources and Services Administration and the Census Bureau. Our study will provide critical information on the extent of disparities in the receipt of GCC and identify potentially modifiable factors to improve health outcomes and reduce diabetes-related costs among Medicaid recipients.