All of us who watch national health care costs know that the United States spends double the money per capita than any other industrialized country. One would hope that such a commitment of resources would result in the highest quality of care and the best possible health outcomes anywhere in the world. Unfortunately, it doesn’t, because more care doesn’t always mean better care.

Our country’s hefty health care bill is footed by a number of parties, with the business community paying the lion’s share for most of us. Despite dramatic increases in the number of working Americans who are uninsured, the majority of Americans are still covered by their employers’ health insurance policies. Naturally, the business community has a vested interest in getting their money’s worth and ensuring that all of their employees receive a level of quality care that companies’ significant expenditures should guarantee.

The frequency of questions about how to achieve high-quality, high-value, equitable, health care call out for national conversations about issues like performance measurement, public reporting and transparency, and I am committed to having those conversations. For decades, the Robert Wood Johnson Foundation (RWJF) has supported programs that help all of us better understand and improve the quality of care. RWJF’s efforts include funding the development of quality measures, designing early pay-for-performance scenarios, developing a new model for providing chronic care, and underwriting efforts to improve the quality of care that people with asthma, diabetes and depression receive. We have also transformed the quality of care people receive at the end of their lives.

In addition to this very useful work, however, we know that really increasing quality in health care also means ensuring equality in health care. That is why we have made a concentrated effort to identify and reduce racial and ethnic disparities in the quality of care that all patients receive.

Earlier this year, the U.S. Census Bureau announced that the country’s minority population had exceeded 100 million, meaning that approximately one in three U.S. residents are non-white. Of the 100 million people of color in America, Hispanics make up the largest segment – totaling more than 44 million or nearly 15 percent of the United States’ overall population. Blacks make up the second-largest group, totaling more than 40 million. If population rates increase as anticipated, about half of America’s population will be non-white within a relatively short period of time.

While we know that a smaller percentage of patients are white, we also know that minority patients receive poorer quality of care. A 1999 Institute of Medicine (IOM) study, Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care, showed that patients of different ethnicities frequently received different levels of care, even when all other factors – including income, education level, health status and insurance coverage – were equal.

With today’s rapidly changing patient demographics, health care providers cannot hope to measurably improve the quality of their care without also identifying and reducing disparities in the care that their minority patients receive. Quite simply, institutions that do not seize this challenge will fail – both in terms of patient satisfaction and the financial health of their institutions.

I firmly believe that improving health care quality will result in better clinical and fiscal outcomes. In order to ensure that health care settings are providing high-quality, high-value, efficient and effective care to all of their patients, institutions nationwide must be prepared to face and address issues surrounding gaps in quality – and racial and ethnic disparities in their care – head-on. It will require looking at quality improvement in a new light.

It will involve engaging all those who have a vested interest in the health care system – consumers, the business community, providers, government leaders, minority leaders, and others. It may involve accepting some difficult truths, identifying innovative solutions and making institutional changes that may meet resistance. Ultimately, however, it is a leap of faith that could safeguard health care institutions for the future, because patients of all races and ethnicities should expect health care that is known for its quality and equality.