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Health Care Reform and Equity: Promise, Pitfalls, and Prescriptions
Kevin Fiscella
Background The United States has made little progress toward greater equity in health care quality. This essay describes the potential promise, pitfalls, and prescriptions in recent health care reforms that could jump-start progress toward more equitable health care.
What This Study Found Recent reforms, particularly the Patient Protection and Affordable Care Act of 2010, offer a historic opportunity to make inroads in addressing health care disparities. Six key health care reform provisions are relevant to promoting equity: improved access, strengthening primary care, enhanced information technology, new payment models, a national quality strategy, and improved disparity monitoring.
Implications
- Health care reforms offer an unprecedented opportunity to create a more equitable, patient-responsive health care system.
- The creations of a more equitable and responsive health system will require effective implementation, improved alignment of resources with patient needs, and most importantly, revitalization of primary care. It may also depend in part on the ability of primary care clinicians to seize these opportunities and champion systems of care responsive to the needs of all patients.