Ensuring Equity for Veterans

Ernest Moy, MD, MPH ’91

Ernest Moy came to Columbia more than 30 years ago for an internal medicine fellowship program for physicians interested in public health. He quickly dug into how socioeconomic factors— education, job stability, neighborhood—could affect patients’ health, something that he is still immersed in today as executive director of the Office of Health Equity of the Veterans Health Administration (VHA).

While earning his MPH, Moy focused on healthcare equity and disparities of care. He found a mentor in Oliver Fein, MD, at what was then called ColumbiaPresbyterian, who had opened five satellite health centers to assist the largely Dominican population in Washington Heights. “He recognized that the social needs they had, especially if they were unmet, were more impactful on their health than anything we could possibly do,” Moy says.

Moy also saw firsthand how bifurcated the U.S. healthcare system can be between those with money and those without. When the hospital decided to take fewer indigent and Medicaid patients, he and the other fellows conducted a study. They found that some were able to pay a new fee, and others found new providers. But some slipped through the cracks. Of this group Moy says, “Their high blood pressure and diabetes were often under poor control.”

Moy went on to work at the Agency for Healthcare Research and Quality, and the Centers for Disease Control and Prevention, where, among other things, he studied rural health disparities. Finally, in 2018, he moved to the VHA. Moy analyzes standard quality metrics—such as safety, effectiveness, and equity—for veterans groups defined by sex, age, race, ethnicity, and other factors. He shares the results with Veterans Affairs (VA) medical centers and clinics around the country. One recent analysis revealed that minority veterans and white female veterans were not receiving newer, more effective diabetes medications at the same rate as white males. “We take that information and tweak our programs,” Moy says. “We might need to customize communication for those groups or connect them to social services.” Making these targeted adjustments to the healthcare program at a VA center, he says, can really move equity forward.