Can Health Equity Be a Moneymaker?

by David Gorn

Sometimes the right thing might also be the financially beneficial thing.

Physician groups are gathering today in Sacramento for a conference on disparities in health care related to race, language and geography. This time, the debate is not just about the moral imperative to promote equity in health care, but also about the clinical and financial impetus to make that move.

"The thing that has changed, as more people are brought into systems of care with accountability, health organizations are going to be looking at avoidable cost as well as avoidable risk," according to Wells Shoemaker, medical director of the California Association of Physician Groups, which  organized the conference."It's sort of the low-hanging fruit when you're looking for avoidable costs."

Californians from different cultures, who speak languages other than English or who live in remote areas are at risk for receiving less or less effective health care than the mainstream. Those same groups often have have a high percentage of chronic health conditions, such as diabetes, obesity and high blood pressure. In an era when more of these people have coverage with the expansion of Medi-Cal, and when health organizations are paid based on efficiency of care, those people may be the ticket to better overall treatment numbers, according to Shoemaker.

"As the dually eligible [those eligible for both Medi-Cal and Medicare benefits] are brought into managed care, as others are brought into ACOs [accountable care organizations], they're going to have to deal with caring for these people," he said. "So, it's not just a social justice issue, but it's a compelling clinical case now, and it will be a business case soon."

Organizations are going to look system-wide to see where care is lacking, he said. "You're going to look for the places you're missing and clog those gaps, and that's when you'll pay attention to disparities," Shoemaker said. "They get a big bang for their buck by looking at disparities."

Today's conference will flesh out some of those ideas, Shoemaker said. Conference organizers hope to send a message to California lawmakers, as well, he said.

"We're hoping that everyone here will get something practical," Shoemaker said, "and that Sacramento hears that we're serous about it, that this is serious."

Paul Taylor
It's about time! People who have serious and persistent mental illness die approximately 25 years sooner than the general population. Providing behavioral health care services and robust benefits under parity laws would dramatically improve health and have a huge primary care savings offset as well. Let's hope the powers that be recognize these facts and do something about it.
Teresa Favuzzi, MSW
When assessing health disparities it is critical to include the experiences of people with disabilities, we are approximately 20% of the population and we often experience barriers related to physical, program and communication access obstacles.

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