The 130th Annual Meeting of APHA

4211.0: Tuesday, November 12, 2002 - 2:40 PM

Abstract #38269

State purchasing and regulatory strategies to reduce racial and ethnic health disparities

Jill E. Rosenthal, MPH, Neva Kaye, and Lynda Gayle Flowers, JD, MSN, RN. National Academy for State Health Policy, 50 Monument Square, Suite 502, Portland, ME 04103, 207-874-6524, jrosenthal@nashp.org

The existence of racial and ethnic disparities in health care is well documented. Despite improvement in the nation’s overall health, minority groups face disparities in the incidence of disease and mortality across a wide range of health conditions, access to health care, and satisfaction with quality of care. State and local health departments are at the forefront of developing public health programs to address racial and ethnic disparities. However, states have other unique opportunities to influence health outcomes for racial and ethnic minorities. As policymakers and as purchasers of health care for a sizable share of the market, states have unique opportunities to leverage their regulatory and purchasing power to achieve policy objectives.

Purchasing and regulatory strategies to address disparities may be discussed within the following framework: Access to insurance coverage; Enrollment in available insurance plans; Access to covered services, clinicians, and health care institutions; Choice of plans, clinicians, and health care institutions; Access to a consistent source of primary care; Access to referral services; Delivery of high-quality health care services

Purchasing strategies that may address disparities include requirements to address language and cultural barriers, outreach activities, collection and analysis of race and ethnicity data for patterns of care, and quality improvement efforts to improve care provided to members of racial and ethnic minority groups or for conditions that disproportionately effect minority groups.

Regulatory strategies may include imposing specific requirements to address disparities as part of professional or facility licensure or reimbursement procedures, hospital conversions from not-for-profit to for-profit status, certificate of need (CON) processes, school-based clinic funding, or health professional student pipeline programs.

The study will present data on the use of purchasing and regulatory strategies to reduce racial and ethnic health disparities through a survey of state Offices of Minority Health (OMH), an E-mail scan of state purchasers and regulators (Medicaid, SCHIP, Insurance, and State Employee Benefits agencies), and follow up phone interviews in eight states. The study also examines the involvement of OMHs in purchasing and regulatory strategies.

Learning Objectives:

Keywords: Minority Health, Policy/Policy Development

Related Web page: www.nashp.org

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Quality Improvement Contributed Papers #2: Racial and Ethnic Disparities

The 130th Annual Meeting of APHA