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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2015. Achieving Health Equity via the Affordable Care Act: Promises, Provisions, and Making Reform a Reality for Diverse Patients: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18551.
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ACHIEVING
HEALTH EQUITY
VIA THE
AFFORDABLE CARE ACT

PROMISES, PROVISIONS, AND MAKING REFORM
A REALITY FOR DIVERSE PATIENTS

Workshop Summary

Karen M. Anderson and Steve Olson, Rapporteurs

Roundtable on the Promotion of Health Equity
and the Elimination of Health Disparities

Board on Population Health and Public Health Practice

Institute of Medicine

images

THE NATIONAL ACADEMIES PRESS
Washington, D.C.
www.nap.edu

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2015. Achieving Health Equity via the Affordable Care Act: Promises, Provisions, and Making Reform a Reality for Diverse Patients: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18551.
×

This activity was supported by a contract and grants between the National Academy of Sciences and Aetna Foundation (12-03699); Connecticut Health Foundation; Kaiser Permanente Program Offices Community Benefit II at the East Bay Community Foundation (20121256); The Kresge Foundation (245367); Merck Sharp & Dohme Corp. (2414); Robert Wood Johnson Foundation (70286); and the U.S. Department of Health and Human Services/Health Resources and Services Administration (HHSH25034010T). The views presented in this publication do not necessarily reflect the views of the organizations or agencies that provided support for the activity.

International Standard Book Number-13: 978-0-309-29463-8
International Standard Book Number-10: 0-309-29463-0
DOI: 10.17226/18551

Additional copies of this workshop summary are available for sale from the National Academies Press, 500 Fifth Street, NW, Keck 360, Washington, DC 20001; (800) 624-6242 or (202) 334-3313; http://www.nap.edu.

Copyright 2015 by the National Academy of Sciences. All rights reserved.

Printed in the United States of America

Suggested citation: National Academies of Sciences, Engineering, and Medicine. 2015. Achieving health equity via the Affordable Care Act: Promises, provisions, and making reform a reality for diverse patients: Workshop summary. Washington, DC: The National Academies Press.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2015. Achieving Health Equity via the Affordable Care Act: Promises, Provisions, and Making Reform a Reality for Diverse Patients: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18551.
×

images

The National Academy of Sciences was established in 1863 by an Act of Congress, signed by President Lincoln, as a private, nongovernmental institution to advise the nation on issues related to science and technology. Members are elected by their peers for outstanding contributions to research. Dr. Ralph J. Cicerone is president.

The National Academy of Engineering was established in 1964 under the charter of the National Academy of Sciences to bring the practices of engineering to advising the nation. Members are elected by their peers for extraordinary contributions to engineering. Dr. C. D. Mote, Jr., is president.

The National Academy of Medicine (formerly the Institute of Medicine) was established in 1970 under the charter of the National Academy of Sciences to advise the nation on medical and health issues. Members are elected by their peers for distinguished contributions to medicine and health. Dr. Victor J. Dzau is president.

The three Academies work together as the National Academies of Sciences, Engineering, and Medicine to provide independent, objective analysis and advice to the nation and conduct other activities to solve complex problems and inform public policy decisions. The Academies also encourage education and research, recognize outstanding contributions to knowledge, and increase public understanding in matters of science, engineering, and medicine.

Learn more about the National Academies of Sciences, Engineering, and Medicine at www.national-academies.org.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2015. Achieving Health Equity via the Affordable Care Act: Promises, Provisions, and Making Reform a Reality for Diverse Patients: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18551.
×

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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2015. Achieving Health Equity via the Affordable Care Act: Promises, Provisions, and Making Reform a Reality for Diverse Patients: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18551.
×

PLANNING COMMITTEE1

PATRICIA BAKER (Chair), Connecticut Health Foundation

GILLIAN BARCLAY, Aetna Foundation

CARA V. JAMES, Centers for Medicare & Medicaid Services

MELENIE MAGNOTTA, Aetna Foundation

PHYLLIS W. MEADOWS, The Kresge Foundation

MILDRED THOMPSON, PolicyLink

ANTONIA M. VILLARRUEL, University of Michigan

WINSTON F. WONG, Kaiser Permanente

__________________

1 The planning committee’s role was limited to planning the workshop, and the workshop summary has been prepared by the workshop rapporteurs as a factual summary of what occurred at the workshop. Statements, recommendations, and opinions expressed are those of individual presenters and participants and are not necessarily endorsed or verified by the Institute of Medicine, and they should not be construed as reflecting any group consensus.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2015. Achieving Health Equity via the Affordable Care Act: Promises, Provisions, and Making Reform a Reality for Diverse Patients: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18551.
×

This page intentionally left blank.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2015. Achieving Health Equity via the Affordable Care Act: Promises, Provisions, and Making Reform a Reality for Diverse Patients: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18551.
×

ROUNDTABLE ON THE PROMOTION OF HEALTH EQUITY AND THE ELIMINATION OF HEALTH DISPARITIES1

ANTONIA M. VILLARRUEL (Chair), Professor and Margaret Bond Simon Dean of Nursing, University of Pennsylvania School of Nursing

MILDRED THOMPSON (Co-Chair), Senior Director and Director of the PolicyLink Center for Health Equity and Place

PATRICIA BAKER, President and CEO, Connecticut Health Foundation

GILLIAN BARCLAY, Vice President, Aetna Foundation

ANNE C. BEAL, Deputy Executive Director, Patient-Centered Outcomes Research Institute

NED CALONGE, President and CEO, The Colorado Trust

IRENE DANKWA-MULLAN, Director, Office of Innovation and Program Coordination, National Institute on Minority Health and Health Disparities, National Institutes of Health

GEM DAUS, Public Health Analyst, Office of Health Equity, Health Resources and Services Administration

JAMILA DAVISON, ACM Medical Transition Care

FRANCISCO GARCIA, Director and Chief Medical Officer, Pima County Department of Health

ALLAN GOLDBERG, Executive Director, U.S. Academic and Professional Affairs, Merck & Co., Inc.

NADINE GRACIA, Deputy Assistant Secretary for Minority Health and Director of the Office of Minority Health at the U.S. Department of Health and Human Services

JEFFREY A. HENDERSON, President and CEO, Black Hills Center for American Indian Health

EVE J. HIGGINBOTHAM, Vice Dean, Perelman School of Medicine, University of Pennsylvania

CARA V. JAMES, Director, Office of Minority Health, Centers for Medicare & Medicaid Services

OCTAVIO MARTINEZ, Executive Director and Clinical Professor, Hogg Foundation for Mental Health, University of Texas at Austin

NEWELL McELWEE, Executive Director, U.S. Outcomes Research, Merck & Co., Inc.

PHYLLIS W. MEADOWS, Senior Fellow, Health Program, The Kresge Foundation

ELENA O. NIGHTINGALE, Scholar in Residence, Institute of Medicine

__________________

1 Institute of Medicine forums and roundtables do not issue, review, or approve individual documents. The responsibility for the published workshop summary rests with the workshop rapporteurs and the institution.

Page viii Cite
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2015. Achieving Health Equity via the Affordable Care Act: Promises, Provisions, and Making Reform a Reality for Diverse Patients: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18551.
×

AMELIE G. RAMIREZ, Director and Professor, University of Texas Health Science Center

JOHN RUFFIN, Retired, National Institute on Minority Health and Health Disparities, National Institutes of Health

MELISSA SIMON, Vice Chair, Clinical Research, Associate Professor, Northwestern University Feinberg School of Medicine

PATTIE TUCKER, Associate Director for Health Equity, Centers for Disease Control and Prevention

ROHIT VARMA, Chair of the Department of Ophthalmology and Visual Sciences and Associate Dean for Strategic Planning, University of Illinois–Chicago

WINSTON F. WONG, Medical Director, Community Benefit, Director Disparities Improvement and Quality Initiatives, Kaiser Permanente

TERRI D. WRIGHT, Director, Center for School, Health and Education, American Public Health Association

IOM Staff

KAREN M. ANDERSON, Senior Program Officer

ANDRÉS GAVIRIA, Research Associate (through August 2013)

ANNA MARTIN, Senior Program Assistant (since February 2015)

ROSE MARIE MARTINEZ, Director, Board on Population Health and Public Health Practice

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2015. Achieving Health Equity via the Affordable Care Act: Promises, Provisions, and Making Reform a Reality for Diverse Patients: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18551.
×

Reviewers

This workshop summary has been reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise, in accordance with procedures approved by the National Research Council’s Report Review Committee. The purpose of this independent review is to provide candid and critical comments that will assist the institution in making its published workshop summary as sound as possible and to ensure that the workshop summary meets institutional standards for objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the process. We wish to thank the following individuals for their review of this workshop summary:

Elizabeth Krause, Connecticut Health Foundation

Menoo Mishra, Association of State and Territorial Health Officials

Jewel Mullen, Connecticut Department of Public Health

Cheri Wilson, Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health

Although the reviewers listed above have provided many constructive comments and suggestions, they did not see the final draft of the workshop summary before its release. The review of this workshop summary was overseen by Elena Fuentes-Afflick, University of California, San Francisco. Appointed by the Institute of Medicine, she was responsible for making certain that an independent examination of this workshop summary was carried out in accordance with institutional procedures and that all review comments were carefully considered. Responsibility for the final content of this workshop summary rests entirely with the rapporteurs and the institution.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2015. Achieving Health Equity via the Affordable Care Act: Promises, Provisions, and Making Reform a Reality for Diverse Patients: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18551.
×

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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2015. Achieving Health Equity via the Affordable Care Act: Promises, Provisions, and Making Reform a Reality for Diverse Patients: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18551.
×
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2015. Achieving Health Equity via the Affordable Care Act: Promises, Provisions, and Making Reform a Reality for Diverse Patients: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18551.
×

Acronyms

ACA Patient Protection and Affordable Care Act
ACO accountable care organization
AHRQ Agency for Healthcare Research and Quality
APRN advanced practice registered nurse
   
CHCS Center for Health Care Strategies
CMS Centers for Medicare & Medicaid Services
   
EHR electronic health record
   
FQHC federally qualified health center
   
HHS U.S. Department of Health and Human Services
   
IOM Institute of Medicine
IRS Internal Revenue Service
   
NCQA National Committee for Quality Assurance
NQF National Quality Forum
   
PCORI Patient-Centered Outcomes Research Institute
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2015. Achieving Health Equity via the Affordable Care Act: Promises, Provisions, and Making Reform a Reality for Diverse Patients: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18551.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2015. Achieving Health Equity via the Affordable Care Act: Promises, Provisions, and Making Reform a Reality for Diverse Patients: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18551.
×
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2015. Achieving Health Equity via the Affordable Care Act: Promises, Provisions, and Making Reform a Reality for Diverse Patients: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18551.
×
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2015. Achieving Health Equity via the Affordable Care Act: Promises, Provisions, and Making Reform a Reality for Diverse Patients: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18551.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2015. Achieving Health Equity via the Affordable Care Act: Promises, Provisions, and Making Reform a Reality for Diverse Patients: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18551.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2015. Achieving Health Equity via the Affordable Care Act: Promises, Provisions, and Making Reform a Reality for Diverse Patients: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18551.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2015. Achieving Health Equity via the Affordable Care Act: Promises, Provisions, and Making Reform a Reality for Diverse Patients: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18551.
×
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2015. Achieving Health Equity via the Affordable Care Act: Promises, Provisions, and Making Reform a Reality for Diverse Patients: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18551.
×
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Page viii Cite
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2015. Achieving Health Equity via the Affordable Care Act: Promises, Provisions, and Making Reform a Reality for Diverse Patients: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18551.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2015. Achieving Health Equity via the Affordable Care Act: Promises, Provisions, and Making Reform a Reality for Diverse Patients: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18551.
×
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2015. Achieving Health Equity via the Affordable Care Act: Promises, Provisions, and Making Reform a Reality for Diverse Patients: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18551.
×
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2015. Achieving Health Equity via the Affordable Care Act: Promises, Provisions, and Making Reform a Reality for Diverse Patients: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18551.
×
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2015. Achieving Health Equity via the Affordable Care Act: Promises, Provisions, and Making Reform a Reality for Diverse Patients: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18551.
×
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Page xiii Cite
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2015. Achieving Health Equity via the Affordable Care Act: Promises, Provisions, and Making Reform a Reality for Diverse Patients: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18551.
×
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2015. Achieving Health Equity via the Affordable Care Act: Promises, Provisions, and Making Reform a Reality for Diverse Patients: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18551.
×
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2015. Achieving Health Equity via the Affordable Care Act: Promises, Provisions, and Making Reform a Reality for Diverse Patients: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18551.
×
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2015. Achieving Health Equity via the Affordable Care Act: Promises, Provisions, and Making Reform a Reality for Diverse Patients: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18551.
×
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Since its creation by the Institute of Medicine (IOM) in 2007, the Roundtable on the Promotion of Health Equity and the Elimination of Health Disparities has been fostering dialogue on racial and ethnic disparities in health and health care, examining the development of programs and strategies to reduce disparities, and encouraging the emergence of new leadership focused on health equity. For the past several years, a prominent topic of discussion within the roundtable has been the Patient Protection and Affordable Care Act (ACA). The ACA has multiple provisions specific to race, ethnicity, and language and other provisions with significant implications for racially and ethnically diverse populations.

In April 2013, the roundtable held a workshop to address many issues surrounding the ACA, including expansion of coverage, delivery systems, and access points, service delivery and payment reform, public-private partnerships, and challenges to the safety net. This report summarizes the presentations and discussions from the workshop.

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