Today the National Quality Forum (NQF) published an important report entitled A Roadmap for Promoting Health Equity and Eliminating Disparities: The Four I’s for Health Equity. NQF is a not-for-profit, nonpartisan organization comprised of diverse public and private stakeholders who use performance measurement to drive quality improvement.

The trend toward value-based care is accelerating, and is more urgent as the climbing costs of care threaten gains in health coverage. As the field is moving toward new ways of paying for value, attention to health care disparities is sorely lacking. Not for lack of need — since the publication of the Institute of Medicine’s Unequal Treatment report, we’ve seen evidence that progress in reducing disparities in care has painfully been slow, or in some cases nonexistent.

President Trump and the Republican Congress have vowed to repeal and replace Obamacare, and Democrats and advocacy groups have pushed back in force. Consumer advocates concerned about the health care of vulnerable populations have focused on preventing loss of health insurance coverage. Insurance companies, for their part, warn that repeal will cause uncertainty in actuarial forecasting, leading to higher premiums and forcing their departure from some markets.