More health systems say they are aiming to close health care disparities. EY’s Susan Garfield outlines steps to help move the needle.
Susan Garfield has been working on health equity issues for 25 years.
“The issues are not new,” she says.
However, Garfiled, head of public health at Ernst & Young (EY), says she is happy that health equity issues are getting more attention from healthcare leaders. Many of these issues have been vividly illustrated in the COVID-19 pandemic.
“COVID has brought health equity challenges and health disparities to the fore,” she says. “It has shown the impact that persistent health disparities and health disparities have.”
“It’s always been a topic that’s real and pervasive,” she says. “It has emerged as a priority for health care organizations.”
EY recently surveyed 500 healthcare executives representing providers, payers and life sciences on health equity. Almost all of those leaders (98%) said their organizations had health equity strategies, and roughly four in five (82%) said they had organization-wide strategies. EY noted that survey participants had to have a role in health equity efforts, so participants were more likely to come from organizations with established strategies.
Garfield spoke about health equity efforts and steps healthcare leaders can take to close disparities. Many health systems have different ideas on strategies for health equity, and that’s a positive thing, she says.
“We are in a period of opportunity, learning and building the foundations for additional and future collaborations,” says Garfield. “It’s not something we’re going to achieve by doing one thing alone.”
Hospitals and health systems can focus on issues such as transportation and connectivity, she says, while payers can look at affordability and access to care.
‘Put it in the center’
Health care leaders who are interested in improving equity in their communities must understand that this must be an organization-wide effort.
“This is an issue that should be at the heart of your strategy,” she says. “When you put it in the center, you can start winning on every front.”
Health systems that can move the needle on closing disparities can build deeper and more lasting connections with their community. They will also improve their reputation in their communities.
“Health equity at its best is an aspirational goal. But closing health disparities and addressing root causes along that continuum……is a meaningful way that health care leaders can change patients’ lives and improve their communities,” says Garfield.
In the EY survey, healthcare leaders most frequently cited a lack of understanding of what health equity actually entails as the biggest barrier they are facing.
More organizations are appointing a chief health equity officer to lead efforts in closing disparities. More than half (58%) of executives surveyed by EY said their organizations have a chief health equity officer.
Some organizations have delegated these responsibilities to members of their executive team. But Garfield said she was “thrilled” to see more organizations investing in health equity officers.
“Certainly it’s helpful in any big transformation like enabling health equity to have someone in charge… It’s not necessary, but it’s really an accelerator and can help organizations achieve their goals more effectively,” says Garfield.
Investments are critical
Healthcare leaders can empower health equity officers by working with other senior leaders to align on key goals. Leaders must agree on what equity efforts will deliver, and organizations must develop the data analytics infrastructure to support those initiatives.
While most organizations say they have strategies to close the gap, many health systems do not have specific budgets for health equity programsaccording to a study by Accenture and HIMSS Market Research published last year.
Garfield suggests that organizations looking to make progress should budget for those equity initiatives.
“Budgets and investments are really critical to support these leaders,” she says.
“Investment needs to be tied to those efforts, so organizations can see ROI, communities can see value, and there’s an incentive to continue investing,” says Garfield.
Health care organizations must engage with their communities to understand the key issues that cause disparities. Almost all respondents (99%) said they recognized the need to work with community members and ensure their inclusion in health equity efforts.
“Nobody should think in isolation from the people they’re trying to serve,” Garfield says.
Data challenges
Healthcare organizations need data to close disparities. While hospitals and health systems have vast amounts of information about their patients, many lack the ability to analyze that data to see where disparities are emerging, such as procedures where members of minority groups may have worse outcomes. bad, says Garfield.
“Most organizations don’t have the analytics infrastructure to take that data and address the root causes of health care disparities,” she says.
A hospital may know that the Hispanic community lags behind other groups in cancer treatments, but the organization may not know what to do with that information, she says. Getting more data can help with interventions.
Less than half (47%) of healthcare organizations say they have reliable data on health equity, according to the EY survey. Systems that don’t have the capacity to analyze their own data may consider finding partners “to build capabilities they don’t have in-house,” says Garfield.
The EY survey also found that 10% of payers said they are not collecting and examining data to track disparities in their populations.
Improve diversity
Systems aiming to close disparities in minority groups should make every effort to improve the diversity of their organizations, Garfield says.
“Incorporating diversity, equity and inclusion efforts is critical on many levels,” she says.
“It also supports your health equity initiatives.”
A diverse physician workforce can help improve interactions with communities, Garfield says.
Garfield notes the lack of diversity in the physician workforce. Only 6.9% of physicians identified as Hispanic, while 5.7% identified as black or African American., according to data from the Association of American Medical Colleges. Much of the challenge is a pipeline issue.
However, health care organizations must make every effort to improve diversity in order to reap benefits in closing disparities, Garfield says.
Health care organizations must recognize that the effort to improve health equity is a long way off.
“This is a big challenge that will take a lot of time, a lot of dedication, a lot of cooperation,” says Garfield.
