Improving health equity shouldn’t just be the responsibility of government and the healthcare system. Employers should work to reduce disparities as well, experts argued in a recent report. In the U.S., about 55% of the population receive insurance coverage from their employers.
“Why must my business play a role? The short answer is that income, economic stability, workplace benefits such as paid time off and medical benefits, and social conditions in the communities where companies operate are major drivers of health disparities, and employers can play a lead role in addressing many of them,” the authors stated in the Harvard Business Review paper, which was published in the January-February edition of the publication’s magazine.
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The report was authored by Dr. Shantanu Nundy, a primary care physician and chief medical officer of Accolade, which is a care navigation company; Dr. Lisa Cooper, a professor of medicine at Johns Hopkins University; and Ellen Kelsay, president and CEO of Business Group on Health.
There are economic implications for not advancing health equity: health disparities cost $320 billion annually, research by Deloitte found.
Here are four ways employers can advance health equity for their employees:
- Improve health plan offerings
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Certain plan designs can create more health disparities, the authors argued. One example of this is co-payments for emergency room visits. Many people in marginalized communities struggle accessing primary care and therefore, lean on the emergency room for routine care.
“So cost-sharing efforts may inadvertently worsen health outcomes for employees most at risk of serious complications,” the authors said.
Improving plan designs can have a major impact on health outcomes. The authors cited a study in the New England Journal of Medicine and Health Affairs, which discovered that patients from minority groups whose employers covered all preventive medications after they experienced a heart attack had 35% fewer major complications, compared to those with co-payments. They also had 70% lower total healthcare costs.
- Targeting social determinants of health
Employers should be investing in benefits that are not “traditionally considered part of medical coverage” but still have an indirect effect on health. One example is Kaiser Permanente’s Thrive Local program, which was created in 2019. It finds members with an unmet social need — like food, housing or transportation — and connects them with a community resource.
Other ways employers can tackle social determinants of health include providing student debt assistance, giving employees access to wages before payday, offering childcare help and assisting with legal services for housing, safety or immigration.
- Leveraging virtual care and community partnerships for primary care and mental health
With about 87 million Americans living in communities without adequate access to primary care and mental health providers, it is vital for employers to provide virtual care for these services, the authors urged. Many large employers provide free or subsidized virtual health services, but they’re often lacking in primary and mental health care, the report stated.
“It’s important for employers to evaluate the virtual services offered by their health plan networks and invest in solutions that offer care that is culturally informed, contextually appropriate, and socially concordant (delivered by clinicians who share a social identity with the employee),” the authors wrote.
Another way employers can expand access is by partnering with community-based providers, like CVS Health or Walgreens.
- Improving navigation
Employees of color are 1.4 to 1.5 times more likely to find resources and tools for benefits insufficient, compared to white employees, according to a 2021 McKinsey study cited by the authors. There are several strategies employers can use to improve care navigation, like using more inclusive language and creating a diverse HR team. They can also train managers to identify employees with an unmet need and connect them with programs.
Additionally, there are navigation services that can assist employees in finding providers who are culturally educated. One example is Included Health, which helps LGBTQ+ employees find LGBTQ+-friendly clinicians.
When it comes to implementing these strategies, certain steps are necessary. Employers need to create a “business case” that quantifies the effect of health disparities on their bottom line, the authors said. They also need to leverage data to understand what needs are unmet, and start with a specific community or health problem instead of taking a more general approach. Lastly, employers need to receive input from employees in marginalized communities.
The report did not mention how much these initiatives cost, but stressed that they will ultimately benefit companies’ financials.
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