Health equity helps ensure all individuals have equal access to healthcare. According to the Centers for Disease Control and Prevention, health equity means everyone has a fair and just opportunity to attain their highest level of health.
To address the benefit needs of underrepresented population groups, payers can develop “more equitable approaches to healthcare benefits design that recognize and meaningfully address access and affordability concerns,” according to a 2022 article in the American Journal of Health Promotion.
With their focus on paying above-average salaries and having rich benefit options, many employers feel this is not a concern in their population. However, they may still find that employees and their families live in areas of concern, such as areas of greater poverty.
Recognizing the health needs of all employees can advance engagement, productivity, and ultimately improved performance. Here are three strategies for healthcare payers to consider when developing benefits plans for equitable coverage for their populations.
1. Begin with leadership buy-in
As payers start thinking about advancing health equity, they must build the business case first. The organization’s leadership must support this approach and prioritize health equity in the corporate health and well-being strategy.
As treatment costs change year-over-year, a percentage known as the medical cost trend, we can expect a 7% medical cost trend in 2024. This is an increase in 2024 for healthcare costs covered by individual and group health plan markets, compared to 6.0% in 2023 and 5.5% in 2022, according to data from PWC.
However, these costs impact different populations differently, which is a foundational point to understand and present when talking with leadership. Even how people allocate their money for health care concerns will vary by population.
2. Understand your data and data sources
Payers can track and measure multiple health and socioeconomic data sources to help ensure their health equity goals and strategies are sound. This includes supplementing their existing data with new and external data resources, such as publicly available data.
For example, the United States Department of Agriculture tracks supermarket accessibility at a Census Tract Level. Food insecurity is an important socioeconomic factor, so merging this data source with existing population health data makes it possible for payers to understand how access to quality food can impact their population’s health outcomes.
Other potential data sources include:
· The CDC/ASTDR Social Vulnerability Index uses U.S. Census data to determine the social vulnerability of every census tract ranked on 16 social factors, including poverty, lack of vehicle access, and crowded housing. It groups them into four related themes: socioeconomics, household characteristics, racial and ethnic minority, and housing type and transportation.
· Health survey data, such as the American Community Survey, can provide insights into the attitudes and behaviors of good nutrition and healthy lifestyles.
· The HUD’s Location Affordability Index can help health plans and employers understand the cost of housing and transportation for their members and employees. These are two of the most significant budget items for most families and can dramatically impact the overall health equity of members. This data can also direct decisions about where to invest in communities.
And the list goes on. Race and ethnicity data emerged as the country moved out of the COVID-19 pandemic. Gender at birth or gender identity data can also be collected. Providers may also capture data about sleep, stress, burnout, tobacco use, and financial concerns during their face-to-face visits with patients. All these factors can play a role in health, and the volume and quality of this data will only grow as providers become more comfortable and effective in capturing it.
Payers can draw insights from healthcare and socioeconomic data to better understand their population by focusing on the right healthcare analytics, visualization, and reporting to these robust data sets. They can also better understand if the third-party vendors they have contracted with to engage their population – for example, a grocery delivery service or wellbeing provider – are helping people who are most in need.
3. Develop a relevant, data-driven engagement strategy
Once the data has revealed which populations need to be engaged, payers must consider how they engage those target populations. The more personalized the communication, the more effective it will drive positive outcomes.
Data can help here, too, so it is valuable to supplement population health data with community information via census tract data. By understanding the community members live in, payers can consider specific barriers when crafting an outreach and engagement strategy.
Here is an example. Aggregated population health data from employers and health plans can identify significant trends. This data shows a significantly higher number of emergency room visits in higher-poverty neighborhoods than in lower-poverty communities.
It is easy to understand why – higher poverty areas may have less access to primary care physicians and reliable transportation, meaning the only choice for care for people living there may be an expensive ER visit with ambulance transport.
By understanding these barriers, employers and health plans can consider how to adapt their communications and engagement strategies appropriately. Engaging with community and neighborhood partners to ensure every member can access quality care regardless of socioeconomic barriers makes sense.
Payers can impact their populations with health equity strategies
So many factors affect health equity, such as affordability of and access to care, ethnicity, geographic location, and socioeconomic status. With an ongoing understanding of the data, payers and employers are equipped to engage those patients who need to be involved to ensure health equity.
About Brandi Hodor
Brandi Hodor is a senior analytic advisor with Merative. She oversees a cross-functional team that can deliver analytics with a commitment to innovative solutions in traditional and value-based care arrangements.
