Integrating Service Utilization and Health Disparities Data into a Strategic Plan for an Urban Indian Community in New Mexico

In 2008 the state legislature formed the Bernalillo County Off Reservation Native American Health Commission and charged it with developing a strategic plan for the health needs of Off-Reservation Indians in the county – the first in-depth review for urban Indians in New Mexico. A new approach was used to develop the plan that integrated (1) demographic baselines; (2) known health disparities for this urban population and (3) their patterns of utilization of health services. We used the census and registrations from IHS to document over 350 different tribes in this community. Claims data were analyzed from the University of New Mexico Health Services; the IHS; the state's Hospital Inpatient discharge data and Medicaid claims for Bernalillo County. We used county level PRAMS data on prenatal services; and surveyed the largest publicly funded clinics in the city of Albuquerque for Native American use. We found gaps in utilization for young adults with chronic diseases once they age out of Medicaid, and that at least 15 percent of hospitalizations for Native Americans were covered by private insurance. Medicaid provided the most comprehensive access data, but in spite of coverage, disparities persisted. Data rebutted myths about how urban Indians sought care. The need for integrated, multi-year data emerged as essential for state and local policy development, and these analyses will be the baseline for trending data over time.