'Health Affairs' Releases Health Care Disparities Issue - October 12, 2011

Health Affairs released its "Agenda For Fighting Disparities" issue on Oct. 6. The issue focuses on the relationship of social and economic determinants to health disparities, the role of environmental factors and the prevalence of disparities in the quality of health care delivered at hospitals. In the issue, U.S. Department of Health and Human Services (HHS) Assistant Secretary for Health Howard Koh, M.D., M.P.H., and colleagues write that “implementation of the Affordable Care Act (ACA) should narrow disparities in health insurance coverage and access and improve primary care services, care coordination and health care quality.” RAND’s Robin Weinick, Ph.D., and Northwestern University's Romana Hasnain-Wynia, Ph.D., argue that not enough attention has been paid to ensuring that the ACA’s quality improvement provisions do not worsen disparities in care. Steven Woolf, M.D., M.P.H., of Virginia Commonwealth University, and colleagues warn that cuts to non–health care programs currently being contemplated in Washington could also exacerbate existing disparities. Finally, Harvard University’s Ashish Jha, M.D., M.P.H., and colleagues analyze quality and cost data and find that hospitals with lower quality and higher costs on average have twice as many elderly African American patients, four times as many elderly Hispanic patients, and 50 percent more Medicaid patients as do hospitals with higher quality and lower costs.

NAPH’s President and Chief Executive Officer Bruce Siegel, M.D., M.P.H., commented on the issue saying, “The results do not reflect those of NAPH members or safety net hospitals in general. According to a recent analysis of Centers for Medicare & Medicaid Services core quality measures, NAPH member hospitals, which serve a disproportionate share of low-income racial and ethnic minorities, performed as good as or better than the national average on 20 of the 24 measures studied.” Siegel also added, “NAPH and its member hospitals are committed to improving equity in care and reducing health care disparities. NAPH and four other major health care organizations are joining together in a nationwide call for action to address racial and ethnic disparities in health care through the Equity of Care Initiative.”