Hospitals in pursuit of excellence

Ensuring Equity: A Post-Reform Framework to Achieve High Performance Health Care for Vulnerable Populations

In the United States, there has been a growing health care divide between vulnerable populations defined in this report as people without health insurance, low-income families, and racial and ethnic minorities and the rest of society. Decades of research has demonstrated that vulnerable Americans are more likely to be in poor health and to experience worse health care outcomes. The Patient Protection and Affordable Care Act (Affordable Care Act) represents substantial progress in addressing the needs of vulnerable populations, most notably by expanding health insurance coverage and bolstering those parts of the health care system that serve the vulnerable. Yet significant additional work remains to be done. This report from the Commission examines the continuing problems facing vulnerable populations and offers a policy framework for moving forward. The framework features three overarching strategies to close the health care divide: 1) ensure that insurance coverage affords adequate health care access and financial protection; 2) strengthen the care delivery systems serving vulnerable populations; and 3) coordinate health care delivery with other community resources, including public health services.