TRUMAN MEDICAL CENTERS

DISPARITIES:Why and What to do About Them?

John W. BlufordPresident/CEO

Truman Medical Centers

Presented to The Institute for Healthcare Disparities

1st Annual National Best Practices Conference

April 17, 2009

1st Annual Conference

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USA Public Policy Overview

• 1860s Bureau of Refugees, Freedmen, and Abandoned Lands

• 1940s Hill-Burton Act The Hospital Survey & Construction Act, 1946

• 1960s Medicare & Medicaid

• 1960-70s OEO Neighborhood Health Centers

• 1973 Health Maintenance Organization Act

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During Slavery

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USA Public Policy

Bureau of Refugees, Freedmen, and Abandoned Lands(“Freedmen’s Bureau”) – 1860s

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Black Hospitals in the U.S.Founded Closed

Freedmen (Howard U.) 1862

George W. Hubbard (Meharry) 1884

Provident, Chicago 1891 1987

Provident, Baltimore 1894 1986

Mercy-Douglas, Philadelphia 1910 1973

Homer G. Philips, St. Louis 1939 1979

Mound Bayou, Mississippi 1941 1983

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USA Public PolicyHill-Burton Act - 1946 (The Hospital Survey & Construction Act)

• Intent– Build & Modernize Hospitals– Separate-but-Equal Funding– Provide Uncompensated Care

• Actual– $4+ Billion Spent from 1946-1978– Unequal Allocation of Resources

Harold H. Burton U.S.

Senator, Ohio Mayor

Lister Hill U.S. Congressman,

Alabama

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Good Samaritan-Waverly HospitalRichland County, South Carolina

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As Opposed to: Major Teaching Hospitals Providing Care for Minorities

• Cook County – Chicago

• Charity – New Orleans

• Grady Memorial – Atlanta

• Jackson Memorial – Miami

• Harlem – New York

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USA Public Policy

• Medicare / Medicaid – 1960s

• Health Maintenance Organization Act – 1973 (HMO Act of 1973)

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What to do about Disparities as an Industry

• Invest in Quality Improvement – “Patient Centered”

• Diversify Governance

• Enhance Community Benefit Reporting

• Focus on Public Health Issues

• Enhance Wellness & Prevention Outreach

• Enhance Diverse Workforce Opportunities

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WHY? Because We Care. We are in the business of caring.

To be effective, we must crossSocial – Economic – Cultural

barriers.