Equity Measures and Systems Reform as Tools for Reducing Racial and Ethnic Disparities in Health Care

Sidney D. Watson, Saint Louis University School of Law Center for Health Law Studies

Abstract

Many health care quality regulators, including officials of the Centers for Medicare and Medicaid Services and other agencies, have embraced systems reform—largely through mandates that require health care providers to implement Quality Assessment and Performance Improvement (QAPI) initiatives. Currently, however, no QAPI requirements stipulate that individual plans or providers measure racial and ethnic disparities. Performance measurements that do not track data by race and ethnicity, the author says, not only miss inequities but are likely to overlook promising techniques for reaching patients of particular racial and ethnic backgrounds. Incorporating equity measures into existing QAPI requirements, the report finds, would not require statutory amendment or new federal regulations. This report provides a template for developing new administrative policies to mandate equity QAPIs and use financial incentives to encourage their adoption.