RN Idaho - May 2021

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FEATURE
Nursing Informatics: Use of the Mapping Medicare
Disparities (MMD) Tool – A Starting Point for Examining
Health Disparity Data in the United States
Barbara McNeil PhD, RN-BC
Adjunct graduate faculty, Gonzaga University
mcneilb@gonzaga.edu
The author has disclosed no potential conflicts of
interest.
As never before and during this pandemic, citizens and
healthcare professionals have seen healthcare data upclose
and embraced and valued it. Through daily analysis
and visual representation of data and trends, the U.S.
media and scientists have increased our understanding
of the spread of COVID-19 across the globe. We are
seeing how certain populations are more affected by
COVID-19 and are developing an understanding of how
social determinants of health influence health outcomes.
The purpose of this paper is to examine the Centers
for Medicare and Medicaid Services Office of Minority
Health’s (CMS OMH) Mapping Medicare Disparities (MMD)
tool (CMS OMH, 2020) and its usefulness for identifying
health disparities across populations, informing the need
for quality of care improvement.
Health Disparities
The term “health disparities” is commonly referred
to as “ differences in health status or health outcomes,
which may be difficult to attribute to individual
providers” (Weissman, et al. 2012, p. 5). Examples of
health disparities include gender, race/ethnicity, income,
education level, sexual orientation, age, and geography.
The concept of “health disparities” differs from
“healthcare disparities” or “health utilization disparities.”
Weissman et al. (2012, p. 5) utilized a National Institute
of Health definition to clarify health disparities as “racial
and ethnic differences in the quality of healthcare that
are not due to access related factors or clinical needs,
preferences, and appropriateness of intervention.” A
research framework and factors influencing health
disparities are shown in Figure 1.
The Medicare Medical Disparities (MMD) Tool
Features
The MMD instrument is a web-based interactive, nocost,
user-friendly tool that was first launched in 2016
(Federal Data Strategy, 2019). Since that time, the tool has
been modified with added search options based on user
input and the changing landscape of health. For example,
users can now compare data from rural and urban
counties; opioid data were added as a condition within the
Population View (Federal Data Strategy, 2019). Through
an interactive search, users can identify geographical
health disparities for 60 chronic conditions for Medicare
populations.
Two Views of the Data: Hospital Versus Population
There are two possible views of the data: Population
View and Hospital View. Data parameters (CMS OMS,
n.d.b) are shown in Table 1 and are used to direct a search.
Nursing Informatics continued on page 22
NIMHD Research Framework
The NIMHD Minority Health and Health Disparities Research Framework reflects an evolving conceptualization of factors relevant to the understanding and promotion of minority health and to the understanding and reduction of health
disparities. The framework serves as a vehicle for encouraging NIMHD- and NIH-supported research that addresses the complex and multi-faceted nature of minority health and health disparities, including research that spans different
domains of influence (Biological, Behavioral, Physical/Built Environment, Sociocultural Environment, Healthcare System) as well as different levels of influence (Individual, Interpersonal, Community, Societal) within those domains. The
framework also provides a classification structure that facilitates analysis of the NIMHD and NIH minority health and health disparities research portfolios to assess progress, gaps, and opportunities. Examples of factors are provided
within each cell of the framework (e.g., Family Microbiome within the Interpersonal-Biological cell). These factors are not intended to be exhaustive. Health disparity populations, as well as other features of this framework, may be adjusted
over time.
Note: This figure and explanation are from: National Institute on Minority Health and Health Disparities. (2017). NIMHD Framework. Retrieved Feb. 9, 20121 from https://www.nimhd.nih.gov/about/overview/
research-framework.html.