How Benefits Providers (and Employers) Can Address Health Inequities

Health equity is top of mind right now for both members and employers. In fact, three in four employers are concerned about inequities in their company’s health and wellbeing initiatives.

That makes sense, given as much as 80% of a person’s health is linked to factors other than medical care, such as where they are born, live, grow up and work. These social determinants of health have a major impact on wellbeing and quality of life. 

At the same time, as health insurance rates continue to rise, some employers are feeling pressure to shift those costs onto employees. That leaves the most vulnerable individuals and families, such as Black and Hispanic adults and those with lower incomes, forced to spend a greater percentage of their discretionary income on medical expenses (either out of pocket or on higher premiums) – or be left with the choice to delay and forgo medical care altogether. 

So, what can we do to address these dual issues of social determinants of health and rising insurance rates being passed onto the most vulnerable individuals?

Addressing Social Determinants

There are many emerging initiatives focused on connecting Medicare and Medicaid beneficiaries with community services to address social determinants of health, including delivery system and payment reform initiatives, as well as referring enrollees to community organizations like housing support services and mobile food programs. While these initiatives are a critical part of achieving a more equitable health system, more attention must be paid to the impact of these social determinants for employer-sponsored health beneficiaries.

Employers want to do better and are setting their sights on having a greater impact on social determinants in the next few years. Change starts with having conversations about barriers for individuals, including the rise in out-of-pocket spending, and recognizing the role that employers can play in reducing these costs. 

Reducing Barriers To Care for All

Gravie’s analytics team is constantly scrutinizing plan data to see what’s possible when providing 100% coverage on the most common healthcare services. Zero-cost primary and specialist care coverage is paramount. Primary care providers are increasingly playing an important role in connecting patients with social services and community-based prevention programs that will help patients follow through on medical recommendations. 

For instance, a doctor may recommend dietary changes and exercise for a patient at risk of heart disease – but individuals may need additional resources if they live in a neighborhood without safe places to exercise or without a grocery store with fresh produce nearby.

Individuals who need to manage a chronic condition, or who may be at a greater risk of one due to social determinants, also benefit from primary care recommendations on healthcare services like cancer screenings, and diagnostics like labs or imaging (which are all completely covered with Comfort®).

Convenient care options, with extensive networks and providers who are actually accepting patients, are also key today. Someone’s location can limit their access to care – as some folks may live in a rural area far away from their doctor or can’t get away from work for an in-person appointment. Gravie health plan members have access to virtual care through Teladoc Health, including general medicine, dermatology and mental health services, and innovative, virtual treatments for back, joint and muscle pain through Sword. 

We must first understand what individual employees and members are going through to help set them on a sustainable path to better health. We envision a future where the biggest barriers to healthcare engagement are eradicated and the longstanding disparities seen in health outcomes are a thing of the past, without breaking the bank for those paying the bill.