New effort enlists businesses to correct health care disparities

Washington -- Offering health insurance is a first step employers can take to improve employees' well-being. A second step increasingly is likely to be taken: ensuring that the health care employees receive adequately addresses the needs of an ever-more-diverse work force.

Striving to eliminate racial and ethnic disparities in health care is now recognized as a good business practice by some large employers, and a new coalition of business, medicine and public health groups has been formed to help advance this goal.

This two-year drive to improve the quality of health care for minority populations was announced Feb. 11 by the National Business Group on Health, a nonprofit organization of large employers, and by the Dept. of Health and Human Services' Office of Minority Health.

The collaborative effort is part of the National Partnership for Action, a broader effort by HHS to end racial and ethnic disparities in health care.

Such disparities have become apparent in recent years with more members of minority groups rating their care as fair or poor than do whites. A 2002 report from the Institute of Medicine, Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care, found that differences existed for a range of conditions, including cancer, cardiovascular disease and HIV infection.

"We must find more effective and far-reaching strategies if we are to succeed in reducing the toll health disparities take on our health, well-being and productivity," said Garth N. Graham, MD, MPH, deputy assistant secretary for minority health at HHS.

Employers are well positioned to address disparities, said Anne C. Beal, MD, MPH, assistant vice president for quality of care at the Commonwealth Fund, a private foundation in New York City that studies health system change. "Not only are employers major purchasers of health care, but they are in position to seek high value for their health care dollar."

Disparities in care are costly, said Helen Darling, president of the National Business Group on Health, and can lead to increased disability among employees and productivity loss for employers.

Organizational policies that extend coverage and make it affordable for all employees and their families are an important first step toward addressing health care disparities, Dr. Beal said. Recent data show that the proportion of adults with employer-based coverage has decreased in recent years, from 68% in 2000 to 63% in 2005, she said.

Another step would be to promote a medical home for employees, Dr. Beal said. "When minority adults had access to a medical home, the quality of their care improved, and there were no disparities in care," she said, citing data in "The Commonwealth Fund 2006 Health Care Quality Survey."

An advisory board co-chaired by Audrietta Izlar, manager of corporate benefits for Verizon Communications, and AMA President Ron Davis, MD, has been created to oversee the new initiative.

The AMA has extensive policy directed at ending racial and ethnic disparities in health care.

"Physicians take primary responsibility for, ownership of and accountability for how health care is delivered," Dr. Davis said.

He drew a distinction between health status, or the morbidity and mortality rates for minority groups that can be traced to socioeconomic factors, and health care individuals receive. "When there are disparities in care, we cannot point to anybody but ourselves."

Organized medicine's approach

To address such disparities, the AMA and the National Medical Assn. formed the Commission to End Health Disparities in 2004. The commission now includes more than 50 state and specialty medical societies and other health professional organizations, Dr. Davis said.

The commission has established several objectives over the years, such as encouraging federal, state and local government actions to eliminate disparities; increasing the diversity within the medical profession; and improving the collection of data in health care settings on patients' race, ethnicity and language.

Actions are under way to address these objectives, he said. One example is a three-hour workshop to educate physicians on how they can improve communication with their minority patients.

The disparities commission also recently extended membership to drugmakers Eli Lilly & Co. and Pfizer Inc. BlueCross BlueShield of Florida is also a member.

The activities of the collaboration between the business group and NHS should mesh well with the physician-led commission, Dr. Davis said. "It will take all of us working together to get this done."