By the year 2050, racial and ethnic minorities are projected to comprise a majority of the U.S. population; however, health and health care disparities are also increasing between majority and minority populations. In order to stem this trend, accurate data collection methods must advance in order for health care equity to ultimately increase across all race/ethnicity groups.

The High-Value Health Care (HVHC) project, supported by staff at the Engelberg Center for Health Care Reform at Brookings, is promoting equity in health care quality through the Racial/Ethnic Health Care Equity Initiative. This initiative engages stakeholders from across the public and private sectors in developing standards and models for collecting and reporting race/ethnicity and language data collection and ensuring that performance measures are grouped appropriately by race/ethnicity and language. Several pilot projects are underway to help develop best practices and solutions to address pressing concerns for race/ethnicity data collection, reporting, and use.

A Regional Study Using Standardized Collection and Reporting

In Montgomery County, MD, racial/ethnic minorities are rapidly approaching a majority status, with persons of Latino or Hispanic descent comprising the largest increases. HVHC project staff at the Engelberg Center are working with Montgomery County as a pilot site for standardized data collection and reporting. In addition to providing standard data collection trainings to all hospitals in Montgomery County, the Center is collaborating with Summit Health Institute for Research and Education (SHIRE) to report on an effort to advance racial/ethnic health care equity in the quality of care delivered.

The pilot project encourages hospitals to use standardized data collection methods and appropriate grouping, by race and Hispanic ethnicity, of 31 performance measures (within four measure sets, including: AMI, Heart Failure, Surgical Care Improvement Project, and Pneumonia). This demonstration will document the process of aggregating hospital data to assess disparities among hospitals in Montgomery County – rather than through analyses of Census and other survey data. At the end of the pilot, staff will provide a Health Care Equity Report detailing the analytic process and health care outcomes by race/ethnicity. This report will help inform the efforts of regional collaboratives (such as the Primary Care Coalition of Montgomery County), community stakeholders, state-wide hospital associations, and others seeking to advance health care equity.

Encouraging Employer and Health Plan Collaboration to Identify Gaps in Health Care Quality

As health care purchasers, employers are uniquely positioned to measure and reduce health care disparities.  In fact, a failure to address health care disparities may result in lost productivity and increased absenteeism among employees.  As part of a call to eliminate disparities, The National Business Group on Health recently released a White Paper detailing the need for employers to partner with health plans on race/ethnicity data collection.   Specifically, NBGH proposes that employers work with health plans to analyze health care performance to identify potential gaps in health care quality. 

The Engelberg Center is collaborating with King County, WA, in a demonstration pilot that will merge Health Risk Assessment data with claims data for more than 17,000 King County employees.  This effort will document the effects of both an employee's and their dependent's health care quality and cost (and health care quality gaps) on that employee's absenteeism and productivity. A report will present a model for employers to use in collecting and reporting health care quality by race/ethnicity, and the report will be shared with the Puget Sound Health Alliance and employer groups seeking to identify new ways to identify and address health care disparities.