Health plans and systems have dabbled in healthy equity readiness over the last few years, but 2022 is the year to implement the necessary transformation to ensure all individuals receive the health care they need and deserve.
Policymakers have made it abundantly clear with new and proposed regulations that health plans have a fundamental responsibility to ensure members have access to quality care, no matter their personal characteristics. It is time for you to incorporate health equity and diversity into your 2022 strategies and tactics to eliminate inequities and disparities.
These challenges and initiatives impact all markets, as regulations now require plans to meet healthy equity requirements for NCQA Accreditation, HEDIS measure success, and state Medicaid mandates, as well as with future CMS requirements outlined in the recently released 2023 Medicare Advantage (MA) and Part D Advance Notice.
Health equity transformation requires you to not only capture data on social factors, such as language, race/ethnicity, sexual identity, and access, but to use the data in a meaningful way to develop person-centric member materials, programs, outreach campaigns, and benefit designs. While this process requires a significant operational shift for your team, there are three areas you can focus on to get started:
Use Tools and Technology to Collect and Act on Holistic Member Data
Invest now in multifaceted and culturally sensitive communication, engagement platforms, and data aggregation tools to truly understand and meet the needs of ALL of your members. The ability to collect comprehensive and accurate member records and stratify social risk factor data will greatly position you to better meet health equity requirements and deliver high-quality care across the entire spectrum of membership. This data should be disseminated across multiple departments to build effective strategies for marketing/sales, product development, supplemental benefits, provider contracts, population health programs, and quality reporting (HEDIS/NCQA/Stars).
Furthermore, capturing member communication preferences enables you to deploy custom outreach strategies to engage with members in their preferred mode (text, e-mail, phone, etc.), especially with excluded or marginalized populations. By making it easier and worthwhile for members to interact and complete required actions, such as through health risk assessments, you can effectively increase utilization rates and CAHPS satisfaction ratings.
Invest in Quality Improvement Strategies That Reach All Members
Implement innovative quality improvement strategies to increase engagement rates and decrease obstacles in receiving necessary health care services. There is no one-size-fits-all approach for addressing social determinants of health, and you will need to think differently about how to reach all members, regardless of their personal circumstances. For example, partnering with community organizations and schools to administer vaccines, expanding methods to get members convenient preventive services kits, and mobile options for mammography and other important screenings enable you to connect members to care in new and creative ways.
Get the Entire Company on Board to Advance Health Equity
Evaluate and enhance organizational policies, procedures, and programs based on new and upcoming health equity requirements. This goes beyond traditional quality programs and work plans. Your teams and departments need to adopt health equity as a shared mission and foster cross-functional collaboration to evaluate current practices and brainstorm new and better ways to engage with members, communities, and health systems.
It is imperative to invest the time and resources now to have enough runway to develop and execute successful tactics for the current and future health equity landscape. If you need assistance, our Consulting & Professional Services Team can provide insight into leveraging sophisticated strategies for advancing whole-person care and addressing social determinants of health. For more information, email me at Kimberly.Swanson@Healthmine.com.