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“Equitable health systems drive the most critical of outcomes for ACOs and payers: healthy, productive employees, and healthy, well-managed patient members,” advises Dr. Veronica Gunn, Chief Executive Officer, Genesis Health Consulting.

Genesis Health Consulting is a service provider at the marcus evans ACO & Payer Leadership Summit January 2021 and the ACO & Payer Leadership Summit April 2021.

What is health equity? And, why does it matter to payers and ACO leaders?

Health equity means that everyone has the tools necessary to live their healthiest life. Achieving health equity requires us to recognize how systems advance or inhibit health for different populations, and then create the tools – social, economic, political, programmatic – to give everyone equal opportunity to live a healthy life. Equitable health systems drive the most critical of outcomes for ACOs and payers: healthy, productive employees and healthy, well-managed patient members.

Do payers/ACO leaders need a separate equity strategy? Or, can equity principles and practices be effectively embedded in existing organizational strategies?

The most effective way to increase health equity is to weave equity principles and practices into organizational strategies, investments, policies and measurement. This approach helps to address systemic contributors to inequities, and supports sustained equity efforts over time. That said, sometimes it is appropriate to articulate a clear equity statement and “starter set” of initiatives and measures. We have used both approaches with our clients. In some ways, it is less important which path you take, as it is to understand which path best sets an organization – with its own culture, priorities and capacity – up for success.

In what ways can payers design benefits, communication practices and incentives to advance health equity amongst their employees? 

Payers may be surprised to learn that many of their employees still experience significant barriers to wellbeing, despite having consistent employment. One action they can take is to assess unmet needs or other barriers to health among their employees, and use the insights to design employee benefits to promote health equity. In addition, payers can evaluate their hiring, promotion and incentive policies and practices, as well as employee communication practices, and eliminate practices that contribute to inequities.

What are the differences and relationships between health equity and social contributors to health?

One can think of health equity as the outcome we seek to achieve. We gauge our progress towards achieving health equity by measuring disparities in health. Services to assess and mitigate social contributors to health are an evidence-based tactic to reduce disparities and create greater equity in health. But, achieving health equity cannot be accomplished with social health services alone. Whether organizations choose an incremental or transformational equity journey, leaders should know that measurable, sustainable gains in equity also require that institutional policies, practices and culture enable equitable access to opportunities and resources for members, patients, and employees.

Are there examples of how payers/ACOs can merge principles and commitment to advancing health equity with the service design and delivery of social health needs (e.g. healthy food, safe housing, stable home environments)? 

Payers and ACOs are leading exciting work to integrate the delivery of social health and care management. For example, some payers have invested in securing stable housing for high utilizers of care to remove housing as a barrier to health. Others have committed to reduce food insecurity as a driver of poor health among their members, and offered rideshare options to enable members to more readily access healthcare.

How can payers/ACOs assess what social health programming/services are critical for their organization to “own”, where to partner, and where to support community-level actions? Are there examples of effective partnerships with local and state governments to achieve these goals?   

The contributors to poor health outcomes are complex, and include all domains of our lives – healthcare, housing, food, community, transportation, education, and others. Payers and ACOs can directly impact some of these social contributors to health, and influence others; however, effective partnership and collaboration with other sectors will be necessary for sustained improvements.

 Ahead of the marcus evans ACO & Payer Leadership Summit January 2021 and the ACO & Payer Leadership Summit April 2021, Dr. Veronica Gunn discusses how equitable health systems drive the best outcomes  

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