MHQP Releases Updated Clinical Guidelines with Renewed Focus on Health Equity

(February 2022)

MHQP has released its updated Clinical Guidelines for 2022. This year, the Guidelines are once again highlighting opportunities for clinicians to reduce inequities in care by improving screening for high-risk populations.

At a time when the pandemic has caused a sharp decrease in routine cancer screenings, and policies that aim to ensure equitable access to appropriate care are being portrayed as “preferential treatment,” these revised Guidelines refocus attention on the biological and social risk factors that should drive appropriate screening care for specific sub-populations.

Clinicians throughout the state have come to depend on MHQP’s Guidelines to move practice for every patient toward consistently applied, evidence based, best practice care. When we issued the first statewide Adult and Pediatric Preventive Care Recommendations and Immunization Guidelines in Massachusetts in 2001, providers were receiving a different set of clinical guidelines from each of the health plans they worked with. Recognizing this situation as both confusing and wasteful, the health plans asked MHQP to step in as a neutral party to create a collaborative set of Guidelines that all plans could support.

Each year since then, we have engaged in an extensive collaborative process to review and update these Guidelines with the most current clinical knowledge and practice. This process begins with a comprehensive review of current literature to assess and incorporate the latest evidence, and ends with an expert advisory panel researching, recommending and reviewing updates to the language.

In the past two years, this review process has included a thorough and thoughtful focus on health equity as a key goal, recognizing that clinical guidelines drive practice. Although we have always included risk factors to encourage risk-based early detection efforts, last year we incorporated a health equity lens to identify subpopulations that are disproportionately at-risk of certain conditions, diseases, and cancers, considering both biological pre-dispositions and social determinants of health.

This year, we have made additional changes to make the risk factors more easily understood at-a-glance. Specifically, we now systematically present the risk factors related to:

• Age
• Racial/ethnic background
• Sexual orientation, gender identity, and expression (SOGIE)
• Family history
• Personal history

These changes move the Guidelines further away from a behavioral paradigm of health and toward general screening personal health history and upstream environmental and social factors.

Here is an example of how the presentation of risk factors for Diabetes (Type 2) and Pre-Diabetes improved from last year to this year:

Another important change in the 2022 Guidelines is that we are now including more descriptive information for the recommended resources (e.g., decision-making aids or relevant articles) related to each condition. This change was recommended by the expert panel to make the relevance of each resource more easily accessible to clinicians. In many cases, the identified resources are included specifically to help clinicians address long-standing health disparities related to that condition.

Here is an example of how the presentation of risk factors for Skin Cancer improved from last year to this year:

“We believe MHQP’s Clinical Guidelines help move us in the right direction for achieving better outcomes for historically underserved populations,” said Natalya Martins, MHQP’s Director of Strategic Initiatives, who leads the process of updating the Guidelines. “We see this as our small contribution to the long overdue, multifaceted effort to address the many, many structural barriers we still need to overcome as a society.”

“We hope our Guidelines will help build awareness among clinicians of the multiple socioeconomic and cultural issues that can impact the health of the diverse populations with whom they work,” said MHQP CEO Barbra Rabson. “Ultimately, we hope the changes we’ve made serve as a step towards improving health outcomes for groups that have been systematically and unfairly affected by the biases embedded in our healthcare system.”

“As we look to improve health outcomes for those at the highest risk for many chronic diseases and cancers, MHQP continues to provide clinicians with equity-based guidelines for life-saving care in our communities,” said Mark Kennedy, Senior Program Manager of the Chronic Disease Division at the Boston Public Health Commission, one of the key champions of MHQP’s Guidelines. “We are continually grateful for their risk-based approach to addressing early detection of disease and mitigation of outcomes disparities.”

You can see MHQP’s 2022 Clinical Guidelines HERE.