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

$$$$$$

$$$$$$

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