Dr. Swift is a Managing Director at PwC, specializing in Whole-Person Care, Population Health Management, and Technology.
Addressing health equity is on the agenda for most healthcare organizations today. However, many consider it an aspirational goal rather than treating it as a mission-driven strategic imperative. Healthcare payers and providers struggle to strike a balance between investing in improving health equity and generating cost savings from it. In order to address the widespread disparities that obstruct the delivery of effective care to disadvantaged patient populations, technology must be part of the solution.
The social determinants of health (SDoH) such as food insecurity, transportation limitations, social isolation, safe living conditions and low income levels are the primary drivers of health disparities across the country. However, there are other drivers such as systemic racism, gender bias and sexual identity discrimination that perpetuate disparities in vulnerable populations. To get in front of these factors, healthcare payers and providers need to rethink the impact that SDoH has on patient outcomes, longitudinal health and overall costs to the healthcare system. In doing so, adjusting payment models and incentive plans to align with addressing health equity can serve as levers for progress. First, let’s focus on technology as an enabler to holistic and equitable care.
Deeply Understand Health Disparities With Advanced Analytics
Leveraging the wide variety of SDoH data that’s largely publicly available can provide organizations with deeper insight into the community-based risks for which they are vulnerable. To impact health equity at scale, healthcare payers and providers not only need visibility into patients’ clinical profiles through medical records and claims data, but they also need population health profiles and socioeconomic profiles. Triangulating these patient data profiles allows for risk scores and patient-centric care plans to be generated through platforms powered by machine learning.
In a global survey conducted by PwC’s Health Research Institute, 47% of consumers indicated healthcare providers are not sharing predictions about which healthcare services they may need in the future, considering their health risks and vulnerabilities. Health consumers may often lack the information or know-how to prevent disease and illness. To truly take care of the whole person, consider using analytics to identify risks and determine interventions that would be best to promote health. Ultimately, investing in advanced analytics for SDoH can enable healthcare organizations to prevent disease and reduce care variation across multiple lines of business and dimensions.
Establish Meaningful Health Equity Metrics
Eliminating health disparities adds value for patients, care providers, health insurance plans and society as a whole. The delta between addressing and capturing a return on investment for social care initiatives is rooted in the way it is tracked and measured. In its white paper, the Institute for Healthcare Improvement stated that “any healthcare organization that prioritizes decreasing health disparities must be prepared to make health equity a system priority—that is, a system-level priority at all levels of the organization—and to profoundly alter the current system that is producing inequitable results.”
To advance health equity, healthcare organizations should design value-based metrics that hold people accountable for providing high-quality and equitable care. From a patient perspective, one meaningful metric that matters is access to healthcare. Tracking and trending the swath of demographic features accessing services across the care delivery ecosystem is a measure of effectiveness for health equity. A broader diversity of patient access points leads to deeper market penetration and enhanced brand affinity as well as an obvious larger customer base to be served.
Measure What Matters Most
Shifting from measuring outcomes to measuring value requires gazing one’s focus upon different things. This shift calls for technology that can support measuring the effectiveness of interventions, vulnerability loop closures and improved quality of life. Recent research published in the International Journal of Environmental Research and Public Health highlights how the “speed of technological innovation has outpaced the industry’s willingness and/or capability to adopt new technologies.” This reality is resulting in many healthcare leaders falling further behind in achieving strategic goals, including those for health equity improvement.
Investment in technologies that support holistic care models, precision medicine and meaningful metrics is the best way to achieve improved population health. Data points that represent care effectiveness can be translated into insights with machine learning algorithms that evolve and become more precise and customized over time. For example, increasing access points for patient care may reveal increased volume and busier clinicians. However, does it always lead to better health, lower risk or improved quality of life? These questions can be answered with predictive algorithms that seek to uncover value-based outcomes that influence the deeper determinants of health.
Start Influencing Health Equity From Within
Healthcare organizations can look within to begin impacting health equity among their own employees. It is likely that the same health disparities and inequities they seek to influence within patient populations also exist within their own workforce. Diversity, equity and inclusion (DEI) campaigns should include health aspects as well. Employees will struggle to be engaged in their work if there are barriers that prevent them from making healthy life choices. These barriers can result in missed shifts and a less vibrant and diverse workforce. A supportive and safe workplace and secure employment are also important social determinants of health.
Employers can take action on workplace environmental factors that research shows have an impact on health status. Robust digital solutions to engage the workforce in wellness, mindfulness and healthful activities can derive a plethora of baseline data for the organization. This data can be used to develop targeted strategies for addressing health equity while also contributing toward creating a happier and healthier workforce, a win-win for all involved.
We should track progress toward a strategic focus on health equity gateway technologies by shifts in capital allocations. These allocations, in turn, can drive more efficient spending on interventions that impact the root causes of health inequities. Now is the time for healthcare organizations to take action on the societal sentiments toward eliminating health disparities by investing in the enabling technologies to understand, measure and tackle them.