Health Affairs, 24, no. 2 (2005): 397 doi: 10.1377/hlthaff.24.2.397 © 2005 by Project HOPE	New Online   How Would Obama, McCain Cover The Uninsured?   Cost To Cover Uninsured   Let Health IT Market Evolve   How Rate Health IT Progress?   HIV/AIDS In India, China

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Insurers' Response

PROLOGUE

Insurers’ Response To Health Disparities

The inaugural NHDR, released in 2003, bolstered and validated these perceptions of inequity by documenting unequivocally that racial, ethnic, and socioeconomic disparities exist on a national scale, are present at all points on the continuum of health care delivery, and run the gamut of medical conditions. Building upon this initial national overview, the 2004 NHDR, as Ernest Moy and colleagues tell us, provides policymakers with insight into assessing the efficacy of national efforts to reduce disparities. Health insurers appear to have realized that a "business case" exists for integrating a response to health disparities into their care delivery models. This sentiment may reflect an awareness that the failure to muster remedial strategies brings with it the potential of inefficient allocation of resources and continuation of costly, ineffective patterns of care, ultimately feeding the perennial problem of spiraling health care spending.

The papers that follow, accordingly, discuss the role of insurers and health insurance in addressing disparities in access to quality care, including those gaps flowing from barriers of language. First, Marsha Lillie-Blanton and Catherine Hoffman explore the extent to which race and ethnicity interact with insurance to influence access. Next, David Nerenz, accompanied by Perspectives from Patricia Hassett and Audrietta Izlar, provides examples of where health plans have leveraged race/ethnicity data to both identify and ameliorate disparities in quality. Cindy Brach, Irene Fraser, and Kathy Paez explore the link between linguistic competence and quality and provide lessons learned from several health plans working to ensure linguistic competence. Finally, Leighton Ku and Glenn Flores describe the evidentiary basis underlying the significance of ensuring access to medical interpretation services for patients, provide a snapshot of the populations most hampered by limited English proficiency, and propose options for adequate financing of interpretation services.

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