Are Hospitals Profiting by Shunning Patients of Color?

U.S. health care system produces worse outcomes for patients of color.
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Photos: USC Annenberg\YouTube

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 re-admissions 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. Read more.

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