Racial and ethnic disparities continue to defy what we expect from our healthcare system. Black and American Indian/Alaska Native people live fewer years, on average, than white people – and are dying from treatable conditions. Minority communities are at a higher risk for chronic, manageable health conditions like asthma, diabetes, heart disease and hypertension, but are less likely to seek out or receive consistent care.
There are many reasons for this ongoing rift – housing standards, available nutrition, education challenges and other social determinants of health. And considering chronic conditions drive about 90% of all healthcare spending, the cost of care weighs heavily upon disproportionately affected racial and ethnic groups.
During my years with the Northeast Business Group on Health, including more than 20 as President & CEO, we studied health inequities and developed resources to help employers address gaps. There’s a lot to tackle, but with increased awareness of the core issues and the courage to rethink healthcare delivery, we can move the needle. Here are some strategies that are already making an impact.
1. Reimagine plan design
No question, health insurance offers working Americans access to needed care. But depending on the health plan design, actually using that insurance can come at a price that makes healthcare flatly unaffordable.
A smart health plan design can ease some of the financial barriers that affect low-income families, many of whom are racial or ethnic minorities. Options include expanding pre-deductible coverage for members with very high deductibles or considering a plan with no deductible at all. Structuring plans that also feature clearly defined copays empower employees to seek needed care, confident they won’t get hit with a bank-breaking surprise bill.
2. Partner with primary care
Navigating the healthcare system is difficult, even for those who work within it. Beyond its borders, it’s so much more complex, especially for those who are less educated, disadvantaged or disenfranchised. Without a primary care doctor to know and trust, getting care can be a prohibitive, expensive maze that’s easier to avoid than access. That means community health suffers, costs increase and the divide widens.
The primary care physician can be a built-in navigator through the complex maze of healthcare. Consider a health plan centered around the primary care relationship, which can restore advocacy to the system and improve population health. Having a provider who knows a plan member’s history helps everyone involved navigate and coordinate needed services with appropriate specialists. Also push for better integration of behavioral health into primary care – another source of systemic gaps and inequities.
3. Deliver culturally aware care
Affordability is key, but truly improving access to care for all also means offering care that meets people where they are. It’s hard to build a trusting foundation without having a mutual understanding of religious, cultural and ethnic influences. This goes for both providers and health plans. To support a thriving provider-patient relationship, health plans must account for language and accessibility barriers that can affect quality of care. Where possible, connect members with providers who understand their cultural background. Communication, training and technology are imperative for bridging the gap.
4. Expand virtual care options
Virtual visits should bring together all of the above, so consider building robust online coverage into your plan. Virtual care offers promise in terms of closing inequity gaps and increasing access to underserved communities, especially for primary and behavioral health care. It removes travel and mobility limitations, both shown to be critical social determinants of health. And it greatly improves options for finding virtual providers who share culture or traditions with patients, even if they aren’t in the same ZIP code.
The realities of inequity in healthcare are disappointing, longstanding and stem from multiple factors in and beyond the system. The goal of achieving the highest level of health for all, with access, advocacy and affordable coverage for all, can be done. Incorporate the four strategies above into your health plan benefit and be part of the solution.
