Table III.3. Selected Firm Perspectives on the Relationship between Quality Improvement and Disparities

Disparities as Culturally Appropriate Care

• Quality and reducing disparities go hand in hand. For example, there is no way to do disease management without addressing culture and language.
• As one firm noted, disparities reduction and quality work are integrally intertwined. The better one knows one's members, the better one can serve them. Hence, while in the past a firm may have assumed "a rising tide raises all boats," there is growing recognition that providers need to be more sensitive to racial and ethnic issues if they are to address the needs of their members.
• Quality can be measured in many ways. Disparities are just another way of looking at quality. There is no single lens that is best. Another firm expressed what seems to be the same view by noting that any market has many segments that must be understood—programs must be tailored to minorities, occupational groups, military members, and others with specific needs.

A Focus on the Distribution (Versus the Mean) in Quality Improvement

• Working on disparities is an important way to improve overall HEDIS performance, complementing overall improvements with targeted improvements on subgroups of the enrollment where the system currently performed less well; this has the potential to raise the overall scores of the organization and its position as a quality leader.
• Disparities are part of overall quality improvement. The issue is not so much reducing disparities as raising overall quality, which in turn means improving care where it is worst.

Return to Document