Can Hospitals Advance Health Equity in the United States? The Influence of Technology, Economics, and Policy

Abstract

In this chapter we make the case that hospitals are in a unique position to advance health equity in the United States. Although often portrayed as a big part of the healthcare cost equation, reimbursement pressures and the shift from acute care to the treatment of chronic illnesses are forcing administrators and clinicians to reconsider not only how and where to treat their patients but at lower costs. Since vulnerable populations, e.g., the uninsured, low-income, and racial/ethnic minority groups are still more likely to visit a hospital emergency department for unnecessary care, there is opportunity for hospitals to leverage their investments in technology to shift costly, inappropriate utilization and reduce the detrimental impacts on health of socioeconomic disparities.

Hospitals can be important partners to recovering accrued and wasted dollars due to failures in care delivery and coordination that are in part responsible for current disparities in outcomes. Reallocating these dollars to and within hospital systems to improve data systems and technologies is essential. With the appropriate policies and economic incentives in place, hospitals can be required to support local surveillance to identify and care for the most disadvantaged patients and, further, to manage patients’ care in alignment with local providers. Knowledge of their local and regional markets allows for the development of place-based care and an opportunity for hospitals to leverage their ability to scale and scope data and technology to improve population health.