Some payers in Colorado are being required to collect demographic data voluntarily given by network providers, including data on race, ethnicity, disability status, sexual orientation and gender identity, according to Kaiser Health News.
Under a rule that took effect March 2, payers are required to collect "demographic data voluntarily submitted by network providers and their front office staff for the carriers' Colorado Option standardized plans."
A state law passed last year requires payers to offer the "Colorado Option," plan on the ACA marketplace. Those plans must have a provider network "that is culturally responsive and reflects the diversity of its enrollees and be no more narrow than the most restrictive non standardized plan offered by the carrier."
Though the law is in effect, Colorado Option plans won't become available until Jan. 1, 2023.
Payers must also create a process for their Colorado Option plan network providers and their "front office staff to annually report on the anti-bias, cultural competency, or similar training that providers and their front office staff have taken in the last year designed to assist covered persons who experience higher rates of health disparities and inequities."
Training timeline:
Fifty percent of a plan's providers and front-office staff must have completed the training by Jan. 1, 75 percent by Jan. 1, 2024, and 90 percent by Jan. 1, 2025.
The state and payers will be able to see how closely patient and provider demographics align and address any gaps.
"Nobody knows how many particular racial or ethnic identities they might have among their providers, what the percentages are and how they correspond with the communities that they serve," Colorado's deputy commissioner for affordability programs, Kyle Brown, told Kaiser Health News. "Traditionally, data like this isn't collected."
Payers will also be required to increase in-network community health centers and certified midwives, according to Kaiser Health News.
Plan directories will be required to list languages spoken by network providers and their front-office staffers, whether provider offices are accessible for people with disabilities, and whether a provider has evening or weekend hours.
Eventually, state officials hope the data could help inform patients by listing providers' demographic data in network directories. Physician groups raised concerns over provider and member safety, leading to the data reporting being voluntary and confidential. The data will also only be reported in aggregate, according to Kaiser Health News.
California and Washington, D.C., currently require plans sold on their ACA marketplaces to collect demographic race and ethnicity data from patients.
CMS said this year it would collect more demographic data, including race, ethnicity, language, sexual orientation, gender identity, disability, income and geography across all public plans.