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New Report Highlights Safety Net Health Plan Efforts to Address Racial Disparities in Health Care

A new report from the Association for Community Affiliated Plans (ACAP) assesses the factors that contribute to racial and ethnic disparities in the health care system, and examines the role of Medicaid health plans in addressing them.

The COVID-19 pandemic has drastically exacerbated existing health disparities in the United States. A March 2020 survey from the Centers for Disease Control and Prevention found that, in 14 states, Black adults made up 33% of hospitalized COVID-19 patients while only representing 18% of the surrounding community. At the time the report was written, the Navajo Nation had higher COVID-19 infection rates per capita than any state in the United States.

“Unfortunately, it doesn’t take a lot of looking to find disparities on the basis of race and ethnicity in our health care system, and COVID has brought many of these persistent, lurking inequities to the surface,” says ACAP CEO Margaret A. Murray. “ACAP believes in access to quality, affordable coverage for everyone. We must continuously work to identify and root out structural racism in health care—and highlight meaningful efforts to eliminate it.”

The ACAP-member Safety Net Health Plans who contributed to the report noted that a lack of prior work and established best practices for addressing health disparities hindered plans’ efforts to resolve these issues. The plans interviewed in this report identified five areas where progress must be made and shared steps they have taken to address health inequities:

• Data Collection and Analysis. Plans noted that state-reported race and ethnicity data are often incomplete and cannot independently provide an accurate picture of enrollees’ race and ethnicity. The AmeriHealth Caritas Family of Companies has implemented uniform approaches across its plans in 13 states to collect race, ethnicity, and language data. AmeriHealth Caritas DC supplements enrollment data provided by the District of Columbia with information gathered through member assessments and medical management interactions. The plan has identified disparities in COVID infection rates and outcomes in the District; Black and Latinx populations have approximately double the percentages of COVID-19 infections compared with the expected based on the ethnic and racial composition of the DC populace.
• Language and Cultural Competency. In addition to meeting state and federal requirements, many plans have undertaken efforts to provide linguistically and culturally appropriate services to plan members. Santa Barbara, CA–based CenCal Health developed a bicultural and bilingual Member Services Department to assist members and partnered with local community organizations to advance health messaging. Texas Children’s Health Plan of Houston mandated intensive cultural competency training for all care coordinators to ensure that all individuals receive culturally respectful assistance.
• Member Engagement. Health Services for Children with Special Needs in Washington, DC hosts monthly community advisory meetings for insights on the challenges plan members face. Using this insight, HSCSN was able to initiate programming specifically to address challenges faced by minority groups during the COVID-19 pandemic.
• Provider Engagement. Plans have noted the important role providers play in addressing racial and ethnic health disparities. Amida Care, a plan launched with the unique goal to provide support to people with HIV/AIDS and other complex health issues, has network providers located in neighborhoods hit hardest by HIV/AIDS, including communities of color. The plan also works with provider organizations that prioritize hiring health providers with high degrees of cultural competency.
• Community Partnerships. ACAP plans recognized that racial and ethnic disparities permeate all aspects of Medicaid enrollees’ lives, including housing, employment, food access, and other social determinants of health that can have a profound impact on health outcomes, so plans have established strong partnerships with community organizations and local governments to close health gaps through improving social conditions.

“This report is a first step,” Murray adds. “We hope it provides a starting point to recognize and remove barriers that keep us from resolving racial disparities in health—a goal to which Safety Net Health Plans are fully committed.”

Read the full report at communityplans.net.

Source: Association for Community Affiliated Plans