Better Health for All Americans: Bending the Arc Toward Justice

Risa Lavizzo-Mourey, M.D., M.B.A., president and CEO of the Robert Wood Johnson Foundation, delivered the keynote at the Institute for the Advancement of Multicultural & Minority Medicine Martin Luther King, Jr. Health Equity Summit on August 23, 2011. This summit, entitled “Enhancing Health Status and Achieving Health Equity at Lowest Cost,” is an annual public review and assessment of the nation’s progress in addressing inequalities in health and reducing health disparities and brings together leaders in health care, academia, industry and consumer/civic organizations as well as federal, state and local officials. In her remarks, Lavizzo-Mourey emphasized that America cannot reconcile the differences that divide us without also reconciling the inequality and injustice embedded so deeply in the health and health care of our people

Cultural Competence: Essential Measurements of Quality for Managed Care Organizations

We are currently witnessing a radical change in the health care system in the United States as a result of the managed care juggernaut. Driven by the imperative to stem increasing health care costs, managed care seeks to save money by “managing” health care utilization and narrowing the choices available to health care consumers. Although both cost-saving strategies are effective, they also present a potential threat to quality of care. As HEDIS and other measures of quality are revised, physicians must establish guidelines for quality of care that support the burgeoning managed health care environment. In developing these guidelines and measures, two important trends must be acknowledged and addressed. First, managed care was formerly confined mostly to middle class populations but now envelops many more diverse and vulnerable groups, including Medicaid, Medicare, and minority populations [1]. Second, providing care within a managed care environment requires attention to the population of “covered lives” in addition to individual patients

Experiences of Minority Primary Care Physicians With Managed Care: A National Survey

OBJECTIVES: To determine if ethnic minority physicians experience more barriers in acquiring and maintaining managed care contracts than white physicians, and to determine if the physician\u27s perceptions of his or her ability to provide appropriate care to patients varies with physician ethnicity. STUDY DESIGN: Using a national sample, we identified 4 research areas germane to this topic and analyzed them by physician ethnic group. METHODS: Analysis involved a pre-existing data set from a national survey that employed a random sampling approach to achieve reasonably accurate national population estimates with acceptable margins of error (95% CI = +/- 2). RESULTS: A total of 1032 primary care physicians completed the survey (response rate of 48%). After controlling for confounding variables, we found that Asian physicians have the most difficulty keeping managed care contracts. Type of practice varies with physician ethnicity, and solo practitioners have more problems securing contracts than physicians in other types of practices. Board-certified physicians are more likely to have managed care contracts than those who are not. Latino physicians have significantly fewer managed care patients than primary care physicians who are white, African American, or Asian. The perceptions of the physicians of their ability to deliver appropriate care overall did not vary by ethnicity, but 2 major subcategories of this item did vary by physician ethnicity: quality of care, and limitations to providing care. CONCLUSIONS: Although we did not find overwhelming evidence of discrimination against ethnic minority physicians, differences in rates of termination, type of practice, board certification rates, and managed care affiliation were related to physician ethnicity

24th Annual Dr. Raymond C. Grandon Lecture: Building a Culture of Health in America

PowerPoint slides at bottom of page. Objectives: After completing this knowledge-based CE activity, participants should be able to: 1. Describe social factors that can influence health outcomes. 2. Identify key elements and components of a culture of health. 3. Examine the role of health provider-community partnerships. 4. Describe the relationship of health and well-being to economic stability and national security. Presentation: 53 minute

Disparities And Quality Improvement: Federal Policy Levers

Using a quality improvement framework to address racial and ethnic disparities in health care highlights multiple opportunities for federal and state governments to exert policy leverage, particularly through their roles as purchasers and regulators. Under such a framework, federal and state governments can expand their roles in collecting race/ethnicity data; define universal and meaningful race/ethnicity categories; more broadly disseminate standards for cultural competence; and demand the reduction of disparities through leveraging their status as collectively the largest U.S. health care payer