Taking Deliberate Steps to Advance Health Equity

Advancing health equity – when everyone has a fair and just opportunity to be as healthy as possible – is not only a moral and social imperative at Elevance Health. It’s also a business imperative. It’s everyone’s business, and everyone’s job.

Health equity is a destination, but it’s also a journey – and definitely more of a marathon than a sprint. Celebrating the wins along the way aids in building the stamina and momentum needed to weather the challenges. These are a few of the wins worth mentioning from 2022.

We have laid the foundation for innovation – enabling a more personalized member experience and better health outcomes. We partnered with the National Committee on Quality Assurance (NCQA), a non-profit organization that provides industry-leading accreditation, in conducting a rigorous assessment of the structure and processes of our health equity work. Our Simply Healthcare plan in Florida was one of nine organizations across the nation that participated in a pilot last summer of NCQA’s Health Equity Plus Accreditation and successfully attained it with a nearly perfect score. We ambitiously embarked on a review of 22 other plans this fall (representing 93% of our Medicaid membership) for NCQA accreditation, which we also successfully achieved. These Medicaid plans are some of the first in the nation to earn the full (3-year commitment) NCQA health equity accreditation. This was truly a team effort that engaged associates across our enterprise and one that will enable us to better serve the whole health needs of our members and the communities in which they live.

We are working to remove social barriers through several avenues.

• The myNEXUS Social Drivers program has been incorporated into the Complex Discharge Planning, Early Interventions, Care Transitions, and Member Connect programs. It provides in-home social drivers of health risk assessments and resource connectivity to help remove social barriers and improve care coordination and delivery — reducing hospitalizations and ER visits as a result.
• We activated our first Social Resource Call Center in 2022, available to 370,000 Missouri Medicaid members through a toll-free number. Social Resource specialists speak with members to identify their questions or concerns, then connect them with information, services, and community resources.
• We are also working to remove social barriers through pharmacy care. Our CarelonRx Pharmacy Care Center is staffed with 400 pharmacists and pharmacy technicians who help remove financial (cost of medication), transportation, and access barriers, which improves adherence with medication treatment plans. They proactively reach out to people who haven’t picked up prescriptions or who are on multiple medications.
  

We are breaking down barriers to improve access to behavioral health services by launching a 988 Spanish-language line to provide text and chat services for Spanish speakers. Dedicated staff from Carelon Behavioral Health are available 24/7 to provide culturally competent crisis services to Spanish speakers, removing a language barrier and advancing health equity by providing greater access to care.

We are partnering with care providers and supporting their continuing education. Care providers are integral partners in the health journey of our members and in advancing health equity. We have a website (www.mydiversepatients.com) that provides free continuing medical education (CME) credit courses on an array of topics that promote providing safe, timely, efficient, culturally relevant, and equitable care. We challenge ourselves to continuous improvement and have more courses scheduled to be available in 2023.

We are diversifying the face of research, moving closer to a more personalized approach to medicine and individualized prevention, treatment, and care. The NIH All of Us Research Program (AoURP) is a historic, longitudinal effort to gather data from one million or more people living in the United States to accelerate research and improve health. We believe the program can help shape the future of healthcare and contribute to solutions for reducing health inequities. In mobilizing our associates, members, and community partners, we’ve helped increase account creations and enrollments in AoURP by greater than 1,000% since fall of 2021.

The Urban Institute, the American Benefits Council, and the Deloitte Health Equity Institute, with support from Elevance Health, led a multi-pronged research engagement to understand the challenges to collecting race and ethnicity data and identify possible solutions for improving its collection and use. We are also conducting our own research to evaluate the impact of our initiatives. Race, ethnicity and socioeconomic data was critical to two of our completed research projects on members’ use of telehealth visits. Both showed that virtual healthcare is a viable tool for advancing heath equity. The first study analyzed use among older adults and ethnically diverse members while the second study focused on use based on socioeconomic status. 

We are further equipping our associates to deliver on advancing health equity. We sent a group of leaders to the Harvard T.H. Chan School of Public Health’s “Leadership Development to Advance Health Equity in Health Care” course in the fall of 2022. This is part of a longer-term plan to develop and offer a custom course annually to a larger cohort of associates and leaders across the enterprise to further cultivate our intentional practice of health equity by design.

I’m reminded daily – whether in meetings, speaking to audiences large or small, or interacting with people in the community – of the incredible opportunity we have to co-architect systems that better enable people to achieve their full health potential. The topics and research I’ve shared in this article are only highlights of what we’re doing or have done so far to advance health equity. It’s nowhere near an exhaustive list.

As excited as I am about what we accomplished in 2022, we’re going to keep pushing for more in 2023. A key goal is to establish an enterprise policy to govern the collection, use, and privacy of sexual orientation and gender identity (SOGI) data. We’ll be launching a care provider diversity campaign and implementing a robust maternal health implicit bias training to improve health outcomes for those thinking about becoming or currently pregnant.

I’m absolutely convinced that it takes all of us together to achieve the progress we're envisioning, from the board room to the community meeting room. I have every confidence in how far we can go.