searching for disparities solutions: “trying harder will not work” michael w. painter, jd, md...
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Searching for Disparities Solutions:Searching for Disparities Solutions:“Trying harder will not work”“Trying harder will not work”
Michael W. Painter, JD, MD
Senior Program Officer
Michael W. Painter, JD, MD
Senior Program Officer
Our Disparities Strategic Objective
Reduce racial and ethnic disparities in the care of cardiovascular disease, diabetes mellitus and depression by 2008
Most think the Federal Government Should Do More…
84%
91%
57%
65%
HispanicAmericans
AfricanAmericans
Whites
Total
Harvard School of Public Health/Robert Wood Johnson Foundation/ ICR, September 2005
Health Care Costs-2004
• $1.9 trillion
• 16% GDP
• $6,280 per person
“The First National Report Card on Quality of Health Care in America”, RAND 2004 (Funded by the Robert Wood Johnson Foundation)
Performance of the U.S. Health Care System
0
2
4
6
8
10
12
1992 1993 1994 1995 1996 1997 1998 1999 2000 2001
Past Disparities Strategies Are Not Working:August 18, 2005, NEJM
Year
CABG
Rat
e (p
er 1
000
enro
llees
) White men
Black menWhite women
Black women
Funded by the Robert Wood Johnson Foundation
The Federal Environment
• Katrina
• Iraq war
• Judicial nominations
• Mounting Federal deficit
• Medicaid cuts
• Medicare Rx benefit
• Rising health care costs
• Rising numbers of uninsured
• Poor care quality and disparities
Mrs. J Needed Quality Care That Was:
• Culturally appropriate
• Evidence based
• Patient centered
QualityQualityCareCare
INNOVATE
Cost SavingsCost Savings
$$$$$$
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PlansPlans
ProvidersProviders
Our Solutions Network Includes:
• Hablamos Juntos
• Legal Barriers Project
• Urban Indian Health Commission
• National Health Plan Collaborative
• Medicaid Plan Collaborative
• Expecting Success
• Finding Answers
• Leading Change
RWJF Solutions Network
ExpectingExpecting
SuccessSuccessLeading Leading
ChangeChange
HablamosHablamos
JuntosJuntos
Plan Plan
CollaborativesCollaboratives
Legal Legal
Barriers Barriers
ProjectProject
Targeted Targeted
ResearchResearch
Finding Finding
AnswersAnswers
RWJFRWJF
Focusing on Next Steps
• Developing a Solutions Network
• Leading the field—Disparities and Quality
• Refining the Research Agenda
• Implementing Effective Interventions
• Focusing on Special Populations
• Turning to Health Information Technology