ACHP: Health Equity Success Requires Holistic, Integrated Approach

August 25, 2021 - In order to achieve health equity, payers must holistically address care disparities and inequities on the individual, community, and systemic levels, according to an Alliance of Community Health Plans (ACHP) white paper.  

In the past year, the coronavirus pandemic has emphasized the need for health equity. ACHP noted that communities of color have experienced higher rates of COVID-19 death and illness compared to their white counterparts.

It is important for payers to address health inequities on individual, community, and systemic levels because, although they are unique, they are all intertwined. ACHP’s recommended integrated approach aims to ensure total health equity for all communities.

The individual level starts with focusing on employees, customers, and members. By starting with their immediate surroundings, payers can lay the groundwork as they move on to the broader levels.

ACHP nonprofit health plans have employed strategies such as employee listening sessions and trainings in which they welcome staff to have open conversations about social justice and health equity factors.

The community level of the health equity movement calls for payers to take a step further and partner with community-based organizations, local government, and public health officials to reach a larger audience.

By partnering with diverse, local leaders, payers can help implement strategies that are tailored to their communities’ specific needs when it comes to tackling care disparities.

In order to create all-around health equity, payers must also address disparities on a systemic level. While this may require a longer timeline than the previous levels, it is essential for payers to address structural issues to ensure health equity for future generations.  

Payers should continue to partner with organizations to implement necessary policy changes and other cultural or economic changes that will reduce health inequities.

ACHP’s nonprofit health plan UCare has applied this three-level strategy in Minnesota to help address healthcare disparities.

The payer partnered with community leaders and employers to improve access to care, support diversity and inclusion, and tackle economic barriers at the individual level.

UCare has taken several actions at the community level including investing in a mobile market that provides affordable healthy food to residents facing food insecurity. The payer holds quarterly stakeholder meetings as well to glean how the company can better address healthcare disparities for seniors and Medicare beneficiaries.

For healthcare workers both within and outside of UCare, the payer offers an online resource that can help healthcare leaders determine whether they and their departments or organizations are upholding health equity.

Finally, UCare has partnered with the Minnesota Medical Association to achieve health equity on the systemic level.

The organizations launched a two-year initiative to start the process of eliminating structural racism in Minnesota’s healthcare system. The initiative prioritizes improving health outcomes in diverse and underserved populations and achieving racial and health equity.

The payer also fought to address economic stability, a key social determinant of health that can stand in the way of achieving health equity. In 2009, UCare helped establish certified peer specialists as approved mental healthcare service providers under Medicaid. This created job opportunities for people who had received substance use and behavioral healthcare treatment.

Several other ACHP health plans have seen success using the three-level holistic approach, as shown in a series of case studies.

Independent Health in Buffalo, New York, joined the community-led African American Health Equity Task Force and helped to reduce the COVID-19 mortality rate in the Black community.

Dean Health Plan in Wisconsin implemented new strategies to address health equity in maternal health, including implicit bias training for employees and social needs screenings for patients. The payer is also partnering with Wisconsin Medicaid to offer coverage for doula services.

“By using the health equity framework above, health care organizations and others can capture the urgency of this moment and drive lasting change,” ACHP concluded. “If you join our efforts, using our holistic approach, imagine the impact locally and nationally. Health plans can’t do it alone.”