Utilization of the Medical Librarian in a State Medicaid Program to Provide Information Services Geared to Health Policy and Health Disparities
Droese, Peter, Peterson, Nancy, Journal of the Medical Library Association
Objective: The role of two solo medical librarians in supporting Medicaid programs by functioning as information specialists at regional and state levels is examined.
Setting: A solo librarian for the Massachusetts Medicaid (MassHealth) program and a solo librarian for the New England States Consortium Systems Organization (NESCSO) functioned as information specialists in context to support Medicaid policy development and clinical, administrative, and program staff for state Medicaid programs.
Brief Description: The librarian for MassHealth initially focused on acquiring library materials and providing research support on culturally competent health care and outreach, as part of the United States Department of Health and Human Services Culturally and Linguistically Appropriate Services in Health Care Standards. The NESCSO librarian focused on state Medicaid system issues surrounding the implementation of the Health Insurance Portability and Accountability Act. The research focus expanded for both the librarians, shaping their roles to more directly support clinical and administrative policy development. Of note, the availability and dissemination of information to policy leaders facilitated efforts to reduce health disparities. In Massachusetts, this led to a state legislative special commission to eliminate health disparities, which released a report in November 2005. On a regional level, the NESCSO librarian provided opportunities for states in New England to share ideas and Medicaid program information. The Centers for Medicaid and Medicare are working with NESCSO to explore the potential for using the NESCSO model for collaboration for other regions of the United States.
Results/Outcomes: With the increased attention on evidence-based health care and reduction of health disparities, medical librarians are called on to support a variety of health care information needs. Nationally, state Medicaid programs are being called on to provide coverage and make complex medical decisions regarding the delivery of benefits. Increasing numbers of beneficiaries and shrinking Medicaid budgets demand effective and proactive decision making to provide quality care and to accomplish the missions of state Medicaid programs. In this environment, the opportunities for information professionals to provide value and knowledge management are increasing.
This paper documents the unique aspects of two medical librarians operating as information specialists Ln context (ISICs) for state Medicaid programs. Library services support Medicaid staff in developing evidence-based health policy with a focus on the quality and delivery of health care to individuals served by the Medicaid program. The ultimate goal of the Medicaid program is to improve the health of its members. Providing access to health care and providing health communication are two objectives of Healthy People 2010 , and these objectives are key to reducing health disparities. Nationally, the Medicaid program is one of the largest purchasers of health care for the poor and underserved. As such, the Medicaid program is an integral part of the national goal of reducing health disparities.
In 1965, Medicaid came into existence under title XIX of the Social Security Act . Medicaid is a joint federal and state program aimed at providing health insurance coverage for low-income children and their parents, elderly, people with disabilities, and people who are categorically eligible. The Medicaid program has experienced an average growth rate of 8% from 2000 to 2003. As the Medicaid rolls increase, the increased costs of the program are a target for lawmakers eager to reduce spending. By virtue of the populations served under Medicaid as well as the skyrocketing costs to deliver benefits to these populations, issues addressing quality of care and health care disparities have gained increased attention.
The Institute of Medicine (IOM) report Unequal Treatment documents the following challenges in addressing health disparities :
* raising public and provider awareness of racial and ethnic disparities in care
* expanding health insurance coverage
* improving the number and capacity of providers in underserved communities
* improving the quality of care
* increasing the knowledgebase on causes and interventions to reduce disparities
The current focus on health disparities as a health policy and public health issue has found a strong voice in political leaders such as Senators Bill Frist (R-TN) and Edward Kennedy (D-MA) [4, 5]. …