As the United States addresses health reform implementation, healthcare managers, administrators, and providers are vying for power in how to shape our national issues. Particular attention has been paid to, in recent times, the disparities in quality health outcomes based on racial, ethnic, and language differences. While rising healthcare costs and the attempts to curb spending have received much of the attention, the solutions are strongly tied to eliminating health disparities. This grand round will explore the working knowledge of health disparities through a health equity lens to explore the implications of managerial solutions as they pertain to health care organizations. It uses systematic, clinical, and social issues of origin to both explain and try to resolve the clinical and administrative connection required to address health equity.