For a number of medical procedures and conditions, patient outcomes are often better at hospitals that perform these procedures or treat these conditions at high rates. There is some evidence indicating that for certain procedures and conditions, white patients receive care at high-volume hospitals at greater rates than minority patients do. For this project, researchers will investigate the scope of these disparities and identify a range of policy solutions. The study will determine: 1) if racial disparities in the use of high-volume hospitals in fact exists; 2) whether such differences are lower among patients enrolled in managed care plans; 3) what the distinguishing characteristics of high-volume hospitals are; and 4) whether disparities are less pronounced for those conditions for which designated 'centers of excellence' exist. The project team will share findings with patient advocates, hospital and managed care officials, purchasers, and others to encourage them to take action. This grant will supplement a new project being undertaken by the Agency for Healthcare Research and Quality.