CHICAGO—During a keynote presentation at the ACHE 2011 Congress Tuesday, Joseph Betancourt, M.D., director of the Disparities Solution Center and program director for multicultural education at Massachusetts General Hospital in Boston, argued that as increasing regulatory pressure mounts to improve health care outcomes for all Americans, work to reduce disparities in health care outcomes for minorities is no longer a matter of choice.

Pointing to emerging Joint Commission standards around patient centered communication, set to take effect next year, and federal mandates in the Affordable Care Act to reduce readmissions and improve overall outcomes—areas where major disparities gaps persist—Betancourt said the financial stakes are too high for hospitals to remain on the sidelines.

"Disparities reduction is moving from a luxury to a necessity," Betancourt said.

Betancourt, who said his first encounter with the challenges of navigating the health care system came as a 7-year-old serving as a translator for his grandmother during a visit to the doctor, noted that health care providers can reduce disparities while simultaneously improving outcomes for all patients. He pointed to the Chelsea Diabetes Disparities Program, a pilot effort launched by Mass General in Chelsea, Mass., that has reduced the gap in diabetes outcomes between Latino patients and white patients while improving overall outcomes for patient control of diabetes. Those gains were made in part with the use of a bilingual health coach working with all patients to drive home the importance of diet, exercise and medication adherence.

"Addressing disparities and quality in one fell swoop…is the way we hope the field will go," Betancourt told me afterwards.

His co-presenter, Joseph Swedish, President and CEO of Michigan-based Trinity Health, made a similar argument about the need for diversity in health care organizations, noting that minorities are expected to comprise 41 percent of the health care work force by 2030, up from 18 percent back in 1980.  Hospitals must begin more aggressively recruiting minorities, Swedish argued, or miss out on cultivating the next generation of leaders.

At Trinity Health, Swedish said, all hospital CEOs are expected to also serve as chief diversity officers, a move he said underscores the significance of diversity in hiring practices.

"I wanted my associates to understand the importance of this issue," Swedish said, "and I wanted my senior leadership to be publicly accountable for these results."

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