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This presentation explores the definition of health disparities and their determinants, the role of the Affordable Care Act, advocacy organizations, data and reporting, community-health systems partnerships, community benefit, and community redevelopment. It highlights ways for consumers to get involved in addressing health disparities and offers suggestions for improvement.
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Advancing Equity and Reducing Disparities: Opportunities for Consumers Doriane C. Miller, MD Next Frontier of Consumer Engagement Aligning Forces For Quality Annual Meeting Washington DC November 12, 2014
Areas for Review • Definition of health disparities • Determinants of health • Role of Affordable Care Act • Advocacy Organizations • Role of data and reporting: macro and micro • Community-Health Systems partnerships • Community Benefit • Community Redevelopment
“Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” Preamble to the Constitution of the World Health Organization as adopted by the International Health Conference, New York, 19-22 June, 1946
Health Disparity: Definition • Differences in health status seen in different populations tied to social, economic and environmental factors
Affordable Care Act Exchange Plans: Best Practices (Community Catalyst) • Ongoing diverse consumer input • Effective language access to services • Robust outreach targeting communities of color • Simplify enrollment and protect privacy • Ensure robust network of safety net providers • Develop quality strategies to reduce disparities
How to get involved • ACA recommends that State Health Exchanges solicit feedback on function: consumers, insurers, advocacy groups and health providers • Find out in your state what programs are in place to provide feedback
Partnership with National Advocacy Organizations • Issue specific • Technical assistance • Multiplier effect • Civic engagement: fraternities, sororities, service organizations
Data: Measurement for Change • ACA requires the collection of data on race, ethnicity (REL) and language for all programs receiving Federal health care funding reported to HHS • Uniform Data Sets (UDS) for Health Resources and Services Administration funded programs: Federally Qualified Health Centers, Migrant Health Centers, Homeless, Public Housing (330 programs) • Measures include REL, preventive care, primary diagnoses for patients treated • Data available thru HRSA website, not user friendly • Consumer role: asking for data about area of health disparities at the local level/population health—linkage to the health delivery system
Community Benefit • Programs and services designed to improve health in communities and increase access to health care • Programs may take place in the community and must have a measurable impact • Must take place in conjunction with a Community Health Needs Assessment—requires community input • Must be made available to the public and reported to the IRS—link to non-profit status
Community-Health Systems Partnerships • Impetus: Population Health Improvement • Influencers: Social Determinants of Health (economics, education, environment, behavior) • Programs/Touch Points: Faith-based, geographic community, schools, housing • Role of Public Health: data, programs, funding, convening
National Quality Strategy • Estimated that ¼ of health care costs are due to modifiable factors • Priority for the inclusion of community efforts that impact health • Development of a framework for health care delivery systems to work with community organizations, public health and the civic sector to improve health
Community Redevelopment: Place Matters • Social ties • Access to healthy foods • Safety • Recreation
Community Redevelopment Agencies: Local Initiative Support Corporations • Helping community residents transform distressed neighborhoods into healthy and sustainable communities of choice and opportunity — good places to work, do business and raise children. LISC mobilizes corporate, government and philanthropic support to provide local community development organizations with • loans, grants and equity investments • local, statewide and national policy support • technical and management assistance
Small Groups • Advocacy • Work with health care delivery systems • Funding/community benefit • Community/public health partnerships • Successes/current activities • Ongoing challenges • Suggestions for improvement