A project of the George Washington University's Hirsh Health Law and Policy Program and the Robert Wood Johnson Foundation

Disparities

HHS enhances CLAS standards

Posted on April 24, 2013

The US Department of Health and Human Services (HHS) Office of Minority Health released enhanced standards on Culturally and Linguistically Appropriate Services (CLAS) in health care settings. There are many determinants that inhibit the achievement of health equity, and the implementation of CLAS is one mechanism by which disparities can begin to be whittled away. Building upon the original 2000 standards, National Standards for Culturally and Linguistically Appropriate Standards in Health and Health Care: A Blueprint for Advancing and Sustaining CLAS Policy and Practice is designed to provide an organization with the information and tools necessary to mitigate health care disparities and achieve health equity by using CLAS. The enhanced standards aim to improve health equality within health care settings by addressing the categories of (1) governance, leadership, and workforce, (2) communication and language assistance, and (3) engagement, continuous improvement, and accountability.

A synopsis of the enhanced CLAS standards is also available.

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Commonwealth Fund issue brief finds health insurance improves outcomes for vulnerable populations

Posted on May 17, 2012

In the U.S., uninsured and low-income adults face significant health and health care inequities as compared to insured and higher-income individuals. An issue brief analyzing the Commonwealth Fund 2010 Biennial Health Insurance Survey finds that when low-income adults have access to health insurance coverage and a medical home, they are less likely to report cost-related access problems, more likely to be up-to-date with preventive screenings, and report greater satisfaction with the quality of their care. Moreover, the gaps in health care between them and higher-income populations are significantly reduced. The Affordable Care Act (ACA) includes numerous provisions that will significantly expand health insurance coverage, especially to low-income patients, as well as provisions to promote medical homes. Along with supporting the full implementation of coverage expansions, it will be important for public and private stakeholders to create opportunities that enhance access to medical homes for vulnerable populations.

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Update: Racial and Ethnic Disparities in Health and Health Care

Posted on December 1, 2011

This post serves as an Implementation Update to our previous Implementation Brief on racial and ethnic disparities, originally posted April 15, 2010. The Update reflects changes made by HHS in their recently-released health survey standards.

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CHIP open to children of low-income State employees

Posted on November 7, 2011

Prior to passage of the Affordable Care Act (ACA), section 2110(b) of the Social Security Act excluded children who were eligible for health benefits coverage under a State health benefits program from CHIP. Over time, however, it became clear that in some States, children of State employees do not have access to affordable, comprehensive coverage options. Many of these children were within the income eligibility level of their State’s CHIP program. Section 10203(b)(2)(D) of the ACA amends the definition of a targeted low-income child by permitting States to extend CHIP eligibility to children of State employees who are otherwise eligible under the State child health plan. At least six states have taken advantage of the new provision.

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HHS releases final standards to measure health care disparities

Posted on October 31, 2011

On October 31st, The U.S. Department of Health and Human Services (HHS) released final standards to measure health care disparities based on race, ethnicity, sex, primary language, and disability status, as required by the Affordable Care Act (ACA). Making these data standards consistent will help identify significant health disparities that often exist between and within ethnic groups. For example, a study showed that the diabetes-related mortality rate for Mexican Americans (251 deaths per 100,000) and Puerto Ricans (204 deaths per 100,000) was twice as high as the diabetes-related mortality rate for Cuban Americans (101 deaths per 100,000). However, these data would have remained unexamined had only the umbrella terms of “Hispanic” or “Latino” been used. By adding different ethnic origins as explicit categories on all HHS-sponsored health surveys, the government hopes to better capture and track the health differences and thus target interventions more appropriately.

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CMS selects 500 FQHCs for Advanced Primary Care Practice demonstration project

Posted on October 24, 2011

The Centers for Medicare and Medicaid Services (CMS) announced today that 500 Federally Qualified Health Centers (FQHCs) have been selected to participate in the Advanced Primary Care Practice demonstration project. These 500 centers will receive $42 million over three years to improve quality and coordination of health care delivery. The project is designed to evaluate the patient-centered medical home model. The goal of the model is to improve patient health and the quality of health care delivery while lowering the cost of of care. HRSA and the Center for Medicare and Medicaid Innovation Center developed the demonstration, which will be conducted from November 1, 2011 through October 31, 2014.

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Update on Essential Health Benefits: The Institute of Medicine Report

Posted on October 21, 2011

Under the Affordable Care Act (ACA) beginning January 1, 2014, state insurance Exchanges become operational and comprehensive insurance market reforms take effect. One of the most significant market reforms is the requirement that all health insurance plans sold in the individual and small group (100 employees or fewer) markets – whether sold outside or inside state insurance Exchanges – cover “essential health benefits” (EHBs). The definition of EHBs also will apply to Medicaid “benchmark” plans, the specified coverage standard for individuals made newly eligible by the ACA’s Medicaid expansions.

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Commonwealth Fund publishes National Scorecard on U.S. Health System Performance, 2011

Posted on October 18, 2011

The Commonwealth Fund debuted the “National Scorecard on U.S. Health System Performance, 2011″ in a press briefing at the Kaiser Family Foundation on October 18, 2011. Cathy Schoen, the Senior Vice President for Research and Evaluation at Commonwealth, summarized the report, which updates a series of comprehensive assessments of U.S. population health and health care quality, access, efficiency, and equity. The report notes substantial improvement on several care quality indicators. However, the U.S. fell short on key measures as well. Across 42 performance indicators, the U.S. achieved a total score of 64 out of a possible 100, when comparing national rates with domestic and international benchmarks. Costs rose sharply, access to care declined, health system efficiency remained low, health disparities persisted, and heath outcomes also fell below target. The Affordable Care Act (ACA) targets many of the important gaps identified by the Commonwealth Scorecard.

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HHS releases review of Healthy People 2010

Posted on October 7, 2011

“Healthy People 2010 Final Review,” released by the U.S. Department of Health and Human Services (HHS), is a progress assessment of the nation’s health goals over the last decade. At a Health Affairs briefing in Washington D.C. just before the release of the Final Review, HHS’s Assistant Secretary for Health, Howard K. Koh, MD, MPH, said that the two principal health goals of the decade were 1) to increase the lifespan and quality of life of Americans, and 2) to reduce health disparities. Secretary Koh reported that the Final Review data show that the first measure, but unfortunately not the second, was achieved. While much progress has been made with regard to 71% of the program’s 2010 targets, the Healthy People Final Review does highlight several critical problem areas, including not only health disparities, but also the obesity rate in America.

For the full “Health People 2010 Final Review,” please refer to the CDC National Center for Health Statistics website.

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Commonwealth’s report suggests policy framework to close health care divide for vulnerable populations

Posted on October 7, 2011

The Commonwealth Fund Commission on a High Performance Health System’s report “Ensuring Equity: A Post-Reform Framework to Achieve High Performance Health Care for Vulnerable Populations” examines the continuing problems facing vulnerable populations and offers a policy framework for moving forward. The framework features three overarching strategies to close the health care divide: 1) ensure that insurance coverage affords adequate health care access and financial protection; 2) strengthen the care delivery systems serving vulnerable populations; and 3) coordinate health care delivery with other community resources, including public health services.

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