The pandemic has thrown into brutal relief the extent to which the U.S. health care system produces worse outcomes for patients of color. And yet there has been scant focus on one of the biggest drivers of structural racism in health care: How doctors and hospitals are paid. Despite waves of well-intentioned payment reforms in recent years, these programs have failed to prioritize the health of people of color, even making it worse in some cases. Programs that penalize hospitals for readmissions may unduly penalize institutions that care for sicker patients, who are often lower-income people of color. Value-based payment programs — which tie payments to quality and cost — can inadvertently lead doctors to avoid patients who are more likely to be dealing with higher rates of chronic illness and social and economic challenges that make it harder for them to achieve good health outcomes. Even when hospitals and providers are making rational decisions to boost their profits and quality scores, such patterns can have the unintended consequence of deepening health inequities and disparities in access to care— a prime example of structural racism. In this webinar, we’ll highlight the ways in which the health care system’s focus on money and good grades is shortchanging the health of communities of color. We’ll explore how good incentives can produce bad outcomes, and identify possible solutions. And we’ll give journalists tough questions to ask of health systems near them: Who is being overlooked in the eternal quest to boost profits?
Amol Navathe, M.D., Ph.D. is an assistant professor of health policy and medicine at the Perelman School of Medicine at the University of Pennsylvania, and a Commissioner of the Medicare Payment Advisory Commission (MedPAC), a non-partisan agency that advises Congress on Medicare policy. He has expertise in policy analysis and design, physician and hospital economic behavior, and application of informatics and predictive analytics to health care. Navathe is a leading scholar on payment model design and evaluation, particularly bundled payments. He founded a disciplinary academic journal, Health Care: The Journal of Delivery Science and Innovation, serving as its co-editor-in-chief, as well as founding director of the Foundation for Healthcare Innovation. His work on health care cost and quality improvement has been published in Science, New England Journal of Medicine, JAMA, Health Affairs, and other leading academic journals. He completed his medical training at the Perelman School of Medicine and his post-graduate medical training at the Brigham and Women’s Hospital at Harvard Medical School. He obtained his PhD in Health Care Management and Economics from The Wharton School.
Marshall Chin, M.D., MPH, the Richard Parrillo Family Distinguished Service Professor of Healthcare Ethics at the University of Chicago, is a general internist and health services researcher with extensive experience caring for marginalized patients and advancing health equity. He co-directs the Robert Wood Johnson Foundation Advancing Health Equity: Leading Care, Payment, and Systems Transformation National Program Office, and co-chairs the Centers for Medicare and Medicaid Services Health Care Payment Learning and Action Network Health Equity Advisory Team. Dr. Chin was elected to the National Academy of Medicine in 2017 and is currently a member of its Council. He obtained his medical degree at the University of California San Francisco School of Medicine and earned a Masters in Public Health from Harvard University.
This webinar is free and made possible by The Commonwealth Fund, the National Institute for Health Care Management Foundation, and The California Endowment.