# Improving Minority Health by Monitoring Medicaid Quality, Disparities and Value

> **NIH NIH R01** · RAND CORPORATION · 2020 · $197,215

## Abstract

PROJECT SUMMARY
Schizophrenia is a serious mental illness associated with a high burden of disease due to severe disability and
premature mortality largely driven by co-occurring chronic medical conditions that shorten life expectancy by at
least 20 years. The broad array of services needed by this population are primarily financed by Medicaid.
Despite high costs, most patients do not receive recommended care, and minorities are less likely to do so
than whites. These pre-existing disparities and the profound social disadvantage also experienced by this
population make them particularly vulnerable to the devastation caused by the COVID-19 pandemic, which in
the US has been particularly severe in the state of New York. New Yorkers with schizophrenia, and minorities
in particular, are not only a high-risk group for poorer COVID-19 outcomes but they may also experience
declines in their health due to disruptions in their ability to access healthcare. Although New York’s Medicaid
program authorized the use of telehealth to mitigate those disruptions soon after the Governor declared a State
of Emergency in early March 2020, the degree to which telehealth has been adopted by Medicaid providers
serving seriously mentally ill people and whether the effects of telehealth adoption may vary by race/ethnicity
are not well known. Our proposed administrative supplement application builds on our ongoing NIMHD-funded
parent study (MD012428), which seeks to reduce healthcare disparities and thus improve health outcomes of
racial/ethnic minority populations through measurement of quality disparities and value (or cost-effectiveness)
of Medicaid-financed care delivered to adults with schizophrenia. Consistent with the NIMHD’s Notice of
Special Interest calling for studies of the impact of the COVID-19 outbreak on health disparity populations, we
propose to evaluate the effects of the outbreak on the racially/ethnically diverse population of Medicaid
beneficiaries with schizophrenia living in New York. In Aim 1, we will assess the effect of the outbreak on
racial/ethnic disparities in access, quality, and effectiveness of mental and physical healthcare delivered to our
study population. In Aim 2, we will assess Medicaid providers’ responses to the outbreak and their effects on
healthcare disparities in our study population. We will characterize provider response through a measure of
provider readiness to adopt telehealth. Our general approach to assessing the impact of the outbreak on
healthcare outcomes and the impact of provider responses on those outcomes will involve the use of post-pre
outbreak differences, interrupted time series approaches, as well as approaches that utilize time-varying
coefficients. In all analyses, our primary interest are parameters that describe how race/ethnicity moderates the
outbreak’s effect on outcomes and the providers’ responses on outcomes. We expect that our work will provide
policymakers with a better understanding of the impac...

## Key facts

- **NIH application ID:** 10169888
- **Project number:** 3R01MD012428-04S1
- **Recipient organization:** RAND CORPORATION
- **Principal Investigator:** Marcela V Horvitz-Lennon
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $197,215
- **Award type:** 3
- **Project period:** 2017-09-20 → 2022-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10169888

## Citation

> US National Institutes of Health, RePORTER application 10169888, Improving Minority Health by Monitoring Medicaid Quality, Disparities and Value (3R01MD012428-04S1). Retrieved via AI Analytics 2026-05-27 from https://api.ai-analytics.org/grant/nih/10169888. Licensed CC0.

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