Eftitan Akam, MD, MPH

2022-2023

Assistant Professor of Medicine, Boston University School of Medicine; Med-Peds Hospitalist, Boston Medical Center, Boston, MA

Eftitan Akam, MD was most recently chief resident physician in Internal Medicine and Pediatrics at Massachusetts General Hospital in Boston, MA. Her long-term career goal is to cultivate national public health work around climate disasters and on-the-ground medical response; she is interested in climate change prevention, disaster preparedness, and humanitarian relief. In 2021, she completed a Fellowship at Auschwitz for the Study of Professional Ethics. Dr. Akam received her medical degree from Vanderbilt University School of Medicine in 2018, and is the co-founder of Melanated and Dedicated (MaD) Scientist outreach Program.

Communicating MassHealth’s Approach to Improving Health Equity Data Collection

Background: Accurate and complete data collection is a fundamental component of efforts to identify and address disparities. Although there has been a recognized need for improved race and ethnicity data collection for more than a decade, the COVID-19 pandemic highlighted the need for expedited health equity efforts, including improved data collection. In the 2020 Medicare and Medicaid Services’ (CMS) data quality assessment of state Medicaid agencies, Massachusetts’ Medicaid and Children’s Health Insurance Program (CHIP), called MassHealth, ranked amongst the five worst performing states at ~50% data completeness. These findings coincided with the commencement of MassHealth’s ambitious health equity initiative, which included plans to improve the quality and completeness of MassHealth’s data. From 2020-2022, MassHealth conducted a comprehensive review of data collection efforts and stakeholder assessment to establish a new method for collecting information related to equity measures. In September 2022, MassHealth received CMS approval for its 1115 waiver request, allowing MassHealth to invest  approximately $2 billion over 5 years to improve health equity. These efforts have culminated in new race and ethnicity data standards, to be implemented in the summer of 2023.

Objectives:

  1. To understand and document MassHealth’s process for the development of its new Data collection instrument
  2. To gain an understanding of health equity data collection standards across stakeholder groups
  3. To assist in establishing a framework for health equity data collection improvement
  4. To publicly communicate MassHealth’s Health Equity data collection framework through a series of academic publications

Methods:

  1. Performed a literature review to understand health equity data collection standards and industry recommendations for race, ethnicity, language, disability, sexual orientation, and gender identity
  2. Reviewed public and internal MassHealth documents detailing findings from stakeholder engagement efforts
  3. Contributed to characterizing a framework that outlines MassHealth’s three-step approach to improving data collection and the agency’s decision process for seven components of data collection.
  4. Co-authored a manuscript draft detailing the above framework.

Results: A draft manuscript is currently under internal review at MassHealth and, when approved, will be published as the first of a series of publications describing MassHealth's efforts to improve collection of different health equity data. This framework was also used to inform an individual comment letter to the Office of Management and Budget regarding their proposed standards for race/ethnicity data collection.

Future Directions:

  1. Continue to refine manuscript with input from MassHealth stakeholders and publish findings
  2. Undertake a similar process as above to communicate data collection of language preference, disability, sex, sexual orientation, gender identity

Preceptor: Michael Chin, MD, University of Massachusetts Chan Medical School/MassHealth