Health equity is transitioning from an idea into tangible change as health system C-suites are investing in projects and initiatives to move the needle for patients.
Health systems are transforming health equity efforts by assigning accountabilities and devising strategic plans with measurable goals to improve the health of their populations and make healthcare more accessible. Sometimes that means leveraging technology for virtual care or remote patient monitoring, while other situations call for a more personalized touch through community liaisons visiting patients wherever they are. It can also mean expanding services inside the hospital to address diverse cultural and social needs, and launching clinician education programs to foster better patient-clinician connections.
Renton, Wash.-based Providence is expanding health equity efforts by expanding access to care and improving outcomes for rural and underserved populations with chronic conditions.
"Providence is poised to have another milestone year in health equity," Whitney Haggerson, vice president of health equity and Medicaid of Providence, told Becker's. "We are gearing up to implement a new health equity strategic plan that expands upon previous years' efforts that helped to reduce inequities in breast and colon cancer, depression screening and diabetes control within the communities we serve."
Ms. Haggerson said the system is also taking a multi-model and multi-lingual approach to engage with different populations and work with a diversified care team, clinical pharmacy and community health workers to meet the needs of underserved populations.
Intermountain Health in Salt Lake City is also elevating health equity. Heidi Wald, MD, chief quality and safety officer of clinical excellence said she is responsible for integrating health equity into the system's clinical excellence portfolio, which touches on quality, safety and patient experience.
"I am excited to center equity in the clinical enterprise, integrate it into our clinical operations and apply modified quality improvement methodology to reduce disparities in clinical outcomes," she told Becker's. "Further, this work will strengthen ties across the organization, tying to our caregiver diversity, equity, inclusion and belonging initiative and our community health efforts."
Vi-Anne Antrum, senior vice president and chief nursing officer of Greensboro, N.C.-based Cone Health, sees advancing value-based care as the most exciting challenge in the coming year.
"This involves putting health equity work front and center, leveraging technology in new ways to enhance our care delivery and free clinicians to do clinical work, expanding our footprint digitally and geographically, taking on more risk, and partnering with our communities and others," she said.
UPMC has a similar focus on improving outcomes and developing innovative initiatives to close gaps in care.
"In 2024, the most exciting challenge for many of us in the healthcare industry lies at the intersection of health equity, quality improvement and outcomes," said Johanna Vidal-Phelan, MD, chief medical officer of quality and pediatrics at UPMC Health Plan. "Advancing health equity involves developing strategies to eliminate disparities in health outcomes among different population groups."
It takes a complex understanding of social determinants of health for organizations to innovate and find ways to address them. Dr. Vidal-Phelan said boosting quality and outcomes needs system member- and provider-centric initiatives to affect change across the continuum of care. UPMC has been recognized for its success in health equity by achieving five stars from CMS for its Medicare Advantage plan and National Committee for Quality Assurance accreditation in health equity.
Joseph Webb, CEO of Nashville (Tenn.) General Hospital, views health equity as an essential aspect of leadership, especially heading a public hospital. Many view Nashville as the "healthcare capital of the world" with large health systems and healthcare companies headquartered there. But the city also ranks poorly in terms of outcomes, and adverse outcomes often disproportionately affect people of color and marginalized populations, Mr. Webb said.
"As the city's public hospital, NGH currently engages in evidence-based healthcare delivery and will have the opportunity to expand and highlight a progressive model of caring for a population of patients without pursuing a distinction of socioeconomic status," said Mr. Webb. "Health equity is critical to any society. Leading a team of participants in the design and build of a tertiary level hospital, focused on maximizing healthcare outcomes across the socioeconomic strata, should generate a high level of excitement for the entire city."
Ngozi Ezike, MD, president and CEO of Sinai Chicago, is focused on closing the health diversity gaps across the city by leveraging technology and community outreach.
"Limited financial resources within a community should not equal a limited lifespan," she told Becker's. "At Sinai Chicago, we remain unwavering in our resolve to close the health disparity gaps seen across our city. The exciting challenge of tackling these gaps involves engaging with partners who share our philosophy that healthcare provision is truly an issue of justice."
She said the hospital is making progress in bridging the digital divide with a new EHR system. They have also increased the number of culturally and linguistically competent caregivers to reflect the diverse patient population.
"Looking ahead, continuing our work to raise visibility and awareness of the critical impact of urban community health systems and the broad-based support needed for our work are our priorities for 2024 and beyond," she said.
Rural health systems are also thinking about what health equity means for them. R. Kyle Kramer, CEO of Day Kimball Healthcare in Putnam, Conn., said there are clear challenges for his rural population in northwest Connecticut to access care because there is a lack of healthcare infrastructure. There are community tools to connect residents with services like ride shares for routine medical appointments, but the services are sometimes hard to access and staffing shortages compound the situation.
He also said Medicaid beneficiaries have a hard time finding providers in rural Connecticut.
"As such, rural providers who do accept Medicaid find themselves overwhelmed," he told Becker's. "At Day Kimball, a major provider in eastern Connecticut, 70 percent of the hospital patient revenue comes from Medicare and Medicaid. For Medicaid patients, the hospital loses anywhere between 40 cents and 60 cents on the dollar. That makes it cost prohibitive for providers to serve people who need it most."