Addressing Health Care Disparities

A Workshop for Senior State Policymakers

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The overall goal of this workshop was to help teams of senior State health officials make more informed decisions concerning the development and implementation of effective programs and policies to address racial and ethnic health care disparities within their jurisdictions.

The following is a summary of this workshop, which was held in New Orleans, Louisiana, on September 15-17, 2003.

About the Workshop Sponsor.

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Overview

A growing body of research has consistently documented disparities in access to, the quality of, and outcomes associated with health care across racial and ethnic populations. The problem of racial and ethnic health care disparities is of particular importance to State and local health policymakers for several reasons:

• Health care disparities have an adverse impact on the overall health status of populations that public policy seeks to protect.
• These disparities raise serious concerns about the quality of care purchased and the value received for expenditures made under State Medicaid, SCHIP, and State employee health benefit programs.
• Understanding the nature and causes of such disparities is critical to the design of effective health care delivery systems in communities across the country.

The problem of health care disparities will soon receive increased attention from the public and policymakers. In the coming months, the Federal Department of Health and Human Services (HHS) will submit to Congress the first annual National Healthcare Disparities Report, which will answer critical questions about health care disparities related to racial and ethnic discrimination. The Agency for Healthcare Research and Quality (AHRQ) has lead responsibility within HHS for the preparation of this report.

Given the significant implications of the problem of health care disparities, the increased public and media attention that the issue will receive with the release of the report to Congress, and the roles State and local governments can play in addressing this problem, AHRQ's User Liaison Program designed this workshop to address the information needs of senior State policymakers on this subject.

Summary of Key Workshop Themes

Context and Framework

The upcoming National Healthcare Disparities Report will provide information about the nature and extent of health care disparities that exist across racial and ethnic groups.

State Perspectives

A number of States have focused attention on racial and ethnic health status disparities, including the development and publication of State-level reports on health status disparities and other programs.

State Strategies

States have a number of policy and programmatic levers at their disposal to help eliminate racial and ethnic heath care disparities.

Promising Approaches

Several Federally-supported, community-focused initiatives offer promising models for addressing change at the local provider and delivery system level.

Purchaser and Health Plan Initiatives

The problem of health care disparities exists at all income levels and within populations who have employer-sponsored health care coverage.

Quality Improvement Efforts

There are a number of methods that can be used by health plans, the State and Federal government, health systems, and providers to address health care disparities through quality improvement efforts.

Medicaid and Other Public Programs

State-administered programs like Medicaid and SCHIP represent useful vehicles through which disparities can be addressed.

Using Data to Design Strategies

An example of how Medicaid claims data and related information can be used to examine variations in utilization, care quality, and outcomes across different Medicaid racial and ethnic populations is presented.

State Action Steps

Steps State teams would like to take to build upon the momentum expected to be generated by the release of the National Healthcare Disparities Report and improve their State's efforts to eliminate racial and ethnic health care disparities are discussed.

AHRQ's User Liaison Program (ULP) disseminates health services research findings in easily understandable and usable formats through interactive workshops. Workshops and other support are planned to meet the needs of Federal, State, and local policymakers, and other health services research users, such as purchasers, administrators, and health plans.

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