Last Friday, HHS released a five point action plan to address racial and ethnic disparities, the latest sign that hospitals, the federal government and other health industry leaders are making a strong push to reduce disparities. The HHS report calls for expanded insurance coverage, new service delivery sites and increased use of patient-centered medical homes. The report comes as the Joint Commission is on the verge of implementing its own standards around patient-centered communication—a key element of disparities reduction efforts—next year.
My sense is that as efforts intensify nationally to control health care costs, health care leaders are beginning to see disparities work not just in the context of delivering high-quality care to all patients, but as a key prong in the overall battle to reduce the high costs associated with patients with multiple chronic conditions. The HHS disparities plan, for instance, specifically notes the presence of disparities in care in cardiovascular disease, childhood obesity and tobacco-related diseases, and recommends targeted efforts in these diseases as part of its overall approach.
That approach—viewing disparities not so much as an isolated area of focus but as a critical component of an integrated quality strategy—was championed by the subject of today's HHN Daily video interview, Joseph Betancourt, M.D., director of the Disparities Solutions Center who also works as a primary care physician at Massachusetts General Hospital in Boston. Betancourt talked up a Mass General program in Chelsea, Mass. that employed a bilingual health coach to improve adherence to diabetes treatment regimens and, ultimately, patient control of the disease. The presence of the coach helped reduce disparities in care for Hispanic patients, but also improved diabetes outcomes for all patients in the program regardless of race or ethnicity, all of whom benefitted from the coach's instruction.
Reducing disparities can be daunting work, of course, and requires a great deal of detailed information. When I interviewed Maulik Joshi, president of the AHA's Health Research Educational Trust, last week to discuss HRET's new report, Improving Health Equity Through Data Collection and Use, he stressed the importance of engaging all staff around the critical first step of acquiring patient data around ethnicity and language, which, given its sensitive nature, can pose a major hurdle.
In the years to come, directives from the Joint Commission and HHS on disparities reduction will force providers to get in the game. And with the innovative work already going on in the field as inspiration, I'm increasingly optimistic that disparities reduction work is moving from an isolated area of hospital operations to a central component of overall patient care strategy.