There’s little question now that health outcomes are impacted not only by medical care, but also by economic stability, education, food access, and even neighborhood. What can payers do to help improve health equity this year? We’ve asked five experts what they recommend.
Prioritize equity—and act on it
“Remember that better health for all begins with equity. Healthcare leaders can leverage predictive analytics to develop an upstream approach to addressing drivers of inequity at the individual and community level, while working to dismantle deeper structural determinants, such as redlining and structural racism.”
- Rishi Manchanda, MD, President and CEO of Health Begins, which helps healthcare professionals improve the social drivers of health and equity
Determine your health equity agenda
"Take the top metrics that are most important in measuring your organization's performance: HEDIS measures; net promoter scores; complaints; ambulatory care-sensitive admissions—whatever is important. Then stratify your results by known axes of inequity: race, ethnicity, gender, principal language, and zip code. The results will give you an agenda for this year's priorities."
- Mark Smith, MD, Co-Chair of the Health Evolution Forum Roundtable on Community Health and Advancing Health Equity
Looking for more ways to improve health equity?
Join us for “From Ideas to Action: Blueprints to Advance Health for All.” Register now for the virtual panel discussion with healthcare leaders.
Assess your data
“It’s critical to ensure you understand any social risk you may be actioning. Do you know who collected the data and how? Are you confident in it? Do you have it in sufficient volume, with sufficient representation across all categories of interest? If assessing affordability or access, does the data fairly represent the financial resources from the poorest to the richest individuals? Plans should consider these questions in the context of broader strategic decision making.”
- Colt Courtright, Chief Data Officer and VP, Corporate Data & Analytics, Premera Blue Cross
Tailor your interventions to those most in need
“Identify those most in need and proactively ensure that they get appropriate care. More care is often provided to those with less true need. Proactively identifying those with the greatest needs and tailoring interventions to ensure that they receive the appropriate care is a crucial responsibility for both payors and providers.”
- Ronald Paulus, MD, CEO of RAPMD Advisors and former President and CEO of Mission Health
Use AI and machine learning
“While there are many approaches to how we can close the care gaps exacerbated by the pandemic that the industry should consider, AI and machine learning technologies must play a key role. These tools can identify individuals at risk of clinical and nonclinical risk factors, such as social determinants of health, that can prevent individuals from receiving the care and services they need. They can also identify how to best engage individuals for better outcomes. That insight is a key asset for plans and providers committed to improving equity and ensuring access to all by enabling them to identify underserved patients and match them to the treatment approaches that best meet their needs.”
- Linda Hand, CEO, Prealize Health
If the pandemic made anything clear, it’s that health outcomes are intertwined with social determinants of health. Make this the year to take proactive steps, wherever there is the highest chance to make a difference.
For more ways to improve healthcare for members, read Prealize’s State of Health Report 2022: The Domino Effect. Based on an analysis of 2021 claims data, the report identifies the top health conditions and utilization spikes healthcare leaders should act on this year.