Efforts to improve quality of care for patients in minority-serving and racially integrated hospitals should focus on the lowest performers, according to a new study in Health Services Research. The study compared quality of care for surgical and pneumonia patients in hospitals with minority patient discharges ranging from zero to more than two-thirds. It found that the high-performing hospitals serving minority and racially integrated patients performed as well as the high-performing hospitals serving mostly white patients. However, low-performing hospitals serving minority and racially integrated patients performed worse than low-performing hospital serving mostly white patients. Policy makers “should design reimbursement schemes that provide appropriate incentive structures for improving quality in all hospitals,” the authors conclude. “Simply rewarding top-performing hospitals with financial bonuses may do little to accomplish this overall goal, while penalizing low-performing hospitals could directly negatively impact care for low-income and minority patients.”