Ending discrimination and systemic racism is essential for an equitable health care system—but addressing discrimination alone does not fully address health equity challenges. Health insurance providers are committed to working with federal, state, and local governments, along with community organizations and other stakeholders to improve health equity so everyone in America has an equal opportunity to thrive and achieve their best health.
Below are actions health insurance providers have taken to advance health equity and make real progress toward this shared commitment.
Aetna Better Health of Nevada, the Medicaid managed care business of Aetna®, a CVS Health® company, donated $65,000 to R.E.A.C.H, a non-profit organization that works to improve community health services and access to care in Nevada. The funding will help individuals with or without health insurance to receive basic health care services at no cost.
Throughout the year, Aetna and R.E.A.C.H. will host ‘La Ruta de la Salud Aetna / The Aetna Route of Health’ community events in low-income areas of Clark and Washoe Counties. The R.E.A.C.H. team will bring its mobile health clinic to each event where individuals and families in attendance can access services at no cost. Services may include basic adult and pediatric wellness exams, vision screenings, glucose, blood pressure and HIV tests. The services offered at each event will vary and staffing may include physicians, pharmacists, social workers, peer support recovery specialists, community health workers, promotoras or others from local organizations and nonprofits.
Modern Healthcare recently released its 2021 Top 25 Diversity Leaders in Healthcare list. This list recognizes health care leaders who have worked to expand and improve access to care for all patients and create inclusive workspaces. AHIP members earning this recognition include:
- Greg Adams, Chairman and CEO of Kaiser Foundation Health Plan and Hospitals
- George Aloth, President and CEO of CareFirst BlueCross BlueShield Community Health Plan District of Columbia
- Ronald Copeland, Senior vice president of national diversity and inclusion strategy; policy and chief equity, inclusion, and diversity officer, Kaiser Foundation Health Plan and Hospitals
- Eric Hunter, President and CEO of CareOregon
- Margaret Larkins-Pettigrew, Senior vice president and chief clinical diversity, equity and inclusion officer, Allegheny Health Network
- Yavar Moghimi, Chief Psychiatric Medical Officer, AmeriHealth Caritas District of Columbia
- Manika Turnbull, Divisional senior vice president, compensation, DEI and workforce experience, Health Care Services Corp.
- Melissa Welch, Chief medical officer, InnovAge
The Indiana Fever and Anthem, Inc. announced a multi-year partnership aimed at addressing social injustice, promoting health and well-being in under-resourced communities, and empowering athletes to become advocates for change. The partnership with the Fever is one of four WNBA franchise partnerships launched by Anthem, with New York, Los Angeles, and Atlanta rounding out the list.
These commitments directly align with Anthem’s work to address long-standing racial and health inequities facing communities across the country and invite each team to partner with Anthem to make a measurable impact on health challenges in their respective cities.
The Blue Cross Blue Shield Association (BCBSA) announced a National Health Equity Strategy to confront the nation’s crisis in racial health disparities. This strategy intends to change the trajectory of heath disparities and re-imagine a more equitable health care system. BCBSA has convened a national advisory panel of doctors, public health experts and community leaders to provide guidance.
The multi-year strategy will focus on four conditions that disproportionately affect communities of color: maternal health, behavioral health, diabetes, and cardiovascular conditions. BCBSA will first focus on maternal health, then behavioral health, in 2021. BCBSA has set a national public goal to reduce racial disparities in maternal health by 50 percent in five years.
BCBSA’s National Health Equity Strategy is comprehensive and relies on close collaboration with providers and local community organizations. This collaboration was essential in recent months as BCBS companies worked with local leaders to support vulnerable communities with COVID-19 vaccine access.
Blue Cross of Idaho and the Blue Cross of Idaho Foundation for Health (the Foundation) joined their sister Blue plans to address health disparities in the United States. Over the next five years, Blue Cross of Idaho and the Foundation will work to gain an even deeper insight on its claims data, member utilization, provider benchmarks and community programs to find measurable clinical objectives and programs that meet the health needs of all Idahoans.
Blue Cross of Idaho and the Blue Cross of Idaho Foundation for Health have a history of expanding health equity in Idaho and will use this opportunity to broaden other projects. These include:
- High-Risk Maternity Management. Blue Cross of Idaho offers a comprehensive program to help pregnant women with acute or chronic health conditions have a safe and healthy pregnancy and childbirth. A Maternity Coordinator conducts a risk assessment with a member which includes questions about physical and behavioral health. After identifying concerns, the member connects with a case manager to craft a personalized care plan in tandem with the member’s provider.
- A $500,000 scholarship fund to the University of Washington School of Medicine’s WWAMI program to support 10 scholarships over the next five years. These scholarships are for Idaho residents who wish to practice medicine in rural Idaho upon becoming physicians.
- A $50,000 grant to Mariman Health, owned and operated by the Coeur d’Alene Tribe, to support the evaluation of the new state-of-the-art community center designed to be a holistic healing center for all tribal members. Mariman Health is a prevention center that will continue to bring positive changes to the rural reservation community, and a safe place for youth to play, learn, for families to heal and be well, and where the community can connect with one another and its Native heritage.
- $30,000 to launch a telehealth pilot program in two rural Idaho counties in partnership with the Idaho Commission for Libraries and two libraries in Orofino and Weippe.
- $5,000-$10,000 per school in technical assistance grants to help implement the Healthy Minds Partnership, an on campus behavioral health program.
Blue Cross and Blue Shield of Illinois (BCBSIL) is providing new resources to help improve the health outcomes of pregnant women and their infants in underserved communities across Illinois.
The United States has the highest maternal and infant mortality rates in comparison to other developed countries, and the statistics are worse for women of color. These disparities are leading to worsening health outcomes for pregnant and post-partum women, particularly in low-income and remote communities. In Illinois, Illinois Department of Public Health shows that non-Hispanic Black women are six times as likely to die of a pregnancy-related condition as non-Hispanic White women.
In an effort to help improve these statistics, BCBSIL is announcing more than $350,000 in grant funding to six community-based organizations working to improve maternal health outcomes on Chicago’s South and West Side neighborhoods. The programs being created or expanded are:
- Catholic Charities Altgeld Gardens Adolescent Parenting Support program. The funding will support a pregnancy and early childhood (age 5+) home visiting program to increase access to health care and address social determinants of health (SDOH) for young mothers ages 14-25. The program also sends doulas to homes from the 3rd trimester through 8 weeks postpartum.
- Chicago Volunteer Doulas Doulas for Health Equity program will use the funding to support its birth doulas program, on-call doula program, postpartum doulas support as well as doula training at the Logan Correctional Center.
- The EverThrive Illinois Chicago Collaborative for Maternal Health, led by AllianceChicago and EverThrive IL, implements a community maternal health intervention that brings together health care and community, social service providers, women and their families, and policymakers to address maternal mortality prevention in Chicago. Grant funds will be used for family education on maternal morbidity and prevention through canvassing, interactive presentations, and train the trainer seminars.
- The Melanated Midwives Maternal Health Project will use the funding to support educational video medicine visits to prenatal and postpartum support during COVID-19.
- Peaceful Birth Practices BCBSIL is funding Sisters Circle Too, which is a 6-week community-based training/mentorship program for women of color specializing in promoting leadership in the field of maternal-child health. BCBSIL funding will help educate providers on the importance of doulas and allowing them access within hospitals.
- The Women’s Care Consulting LLC Enhancing Access to Women’s Health Care through Telemedicine program will improve availability of telehealth and counseling in early pregnancy and postpartum.
This Maternal Health initiative is one of the ways BCBSIL is reinvesting payments from the Illinois Department of Healthcare and Family Services for providing quality care to Medicaid members.
Blue Cross Blue Shield of Massachusetts (“Blue Cross”) and the Blue Cross Blue Shield Association (“BCBSA”) has announced a national health equity strategy to help address racial health disparities. This strategy aims to change the trajectory of health disparities and re-imagine a more equitable health care system by:
- Collecting data to measure disparities
- Scaling effective programs
- Working with clinical partners to improve outcomes and address unconscious bias
- Forming partnerships at the community level
- Influencing policy decisions at the state and federal levels
This national strategy will complement BCBSMA’s already-established goal of making meaningful and sustained progress toward health equity.
Blue Cross North Carolina has invested more than $2 million in organizations serving diverse communities, including:
- NC School of Science and Math
Sponsorship of Step up to STEM (science, technology, engineering and mathematics combined) academic summer program, a virtual project-based learning camp for African American, Latino and Native American students, rising to 9th and 10th grade, to explore STEM fields and careers.
- March of Dimes
Breaking Through Bias in Maternity Care, a virtual course providing insights to doctors and health care professionals to help them recognize implicit bias in maternity care settings and provides content to providers caring for women before, during and after pregnancy.
- El Futuro
Mental Health Treatment Initiative for Latino families that supports improved access to higher quality care, reduced disparities in rural health care, better engagement with rural providers, improved mental health outcomes and creating a model program in a pay-for-value-based environment.
Thompson Child & Family Focus (Thompson), in collaboration with Healthy Blue, Blue Cross and Blue Shield of North Carolina’s (Blue Cross NC) Medicaid managed care plan, is launching a model of home-based family trauma treatment services in Cumberland County for families within underserved communities. The model will specifically help communities with relatively high percentages of individuals in the child welfare system that are placed outside of the home.
Family Centered Treatment (FCT), an evidence-based practice created by clinicians, is aimed at providing long-term stabilization services to families with youth that may move between the child welfare and juvenile justice systems and who may be at-risk of unfavorable, potentially traumatic situations such as removal from the home. The program is currently staffing for clinicians, and through the collaboration with Healthy Blue, Thompson will imbed a team of FCT clinicians into the Cumberland County region to serve area youth and families.
The FCT model and its family-led approach differentiates the program from other therapy models that focus solely on children, and in some ways neglect the needs of the other individuals within the family in the process. The model has been shown to lead to positive outcomes within the home, such as decreased removal rates, and overall increased stability of the family unit. Ninety percent of families who complete treatment, maintain family placement, avoid out-of-home placement or are reunified with their families. Thompson looks to create similar outcomes in the Cumberland County region through the collaboration with Healthy Blue.
The goal is to introduce FCT to the family prior to any sort of need for removal due to instability, and to increase access to these resources to communities that haven’t historically had access.
FCT is currently used in more than 10 states across the U.S. and is growing in popularity by human services organizations like Thompson, which is one of only three organizations across the state of North Carolina currently serving families with FCT.
Blue Shield of California announced $300,000 in community investments to nonprofit organizations that advance the health and well-being of youth and communities of color. The funding supports initiatives focused on youth development, social justice, and health equity.
Twelve organizations – six in the San Francisco Bay Area and six in the Inland Empire region of Southern California – will each receive $25,000 for a range of initiatives, including art programs, mentorship, technology training, housing, and social justice activism.
The announcement builds on the work of Blue Shield’s signature BlueSky youth mental health initiative. Blue Shield created BlueSky because youth mental illness is a pressing issue that demands early intervention: it’s the number one reason California children are hospitalized, and half of all lifetime cases begin by the age of 14.
Since Blue Shield’s BlueSky initiative launched in 2019 it has funded more than 6,700 youth counseling sessions in 20 middle and high schools in San Diego and Alameda Counties, and supported Youth Mental Health First Aid training for more than 2,000 educators statewide.
Cambia Health Solutions proudly announced that it received a fifth consecutive score of 100 percent on the Human Rights Campaign Foundation’s 2021 Corporate Equality Index (CEI), the nation’s foremost benchmarking survey and report measuring corporate policies and practices related to LGBTQ workplace equality. Cambia Health Solutions joins the ranks of 767 major U.S. businesses that also earned top marks this year.
Cambia is committed to driving inclusive health innovation based on diverse perspectives and experiences. The company recruits for diverse and equitable representation, viewing diversity as an individual’s inherent and acquired characteristics. Cambia looks forward to leveraging the Institute for Healthcare Improvement’s health equity framework to continue this work through 2021.
CareFirst released the following statement on social justice and addressing disparities in America’s health care system. The statement reads in part:
“It has been a long year of reckoning which has shown a bright and often painful light on the inequities Black and Brown people experience in America on a day-to-day basis, too often with deadly consequences. As a healthcare company, we witness the grave impacts in the communities we serve as a direct result of the systemic disparities that persist in the United States healthcare system.
“We encourage our associates and communities to continue, with urgency, to demand equity and to pursue social justice as a right and reality enjoyed by all. The health of our communities depends on it. Equally important, we are hopeful each of us will recognize the importance of caring for one another and opening ourselves to the shared work ahead with empathy, humility, and compassion.
“We serve millions of people and have a profound responsibility to stand up for their health in every moment of their lives. And we will.
“We will continue to lead with and for our associates and the communities we serve to advance meaningful change. CareFirst supports and encourages thoughtful, peaceful, and intentional advocacy and remains committed to advancing diversity, equity, and inclusion in all we do.
“Better is possible. We will do our part.”
The Pacers and CareSource announced a multi-year agreement that will include partnership on the Live, Learn, & Play initiative, an effort to help local schools create environments conducive to student success. As a result of the partnership, CareSource also becomes title partner for the CareSource Courtside Club and will have prominent branding throughout the arena.
Pacers Sports & Entertainment has a goal to use its charitable resources for intentional generosity in intentional geography, an effort that means developing meaningful partnerships with other Indiana companies investing in change. CareSource, a nonprofit managed care provider for the Healthy Indiana Plan and Hoosier Healthwise, has a long track record of partnering with State agencies and other nonprofit organizations in support of Indiana’s most vulnerable families.
Live, Learn, & Play will result in refurbished spaces, improved technology, and a focus on literacy for students in Indianapolis public schools. In addition to sponsorship of this program, CareSource and PS&E will collaborate on future efforts to promote public health, reduce recidivism, and support families in some of Indiana’s most vulnerable zip codes.
CareSource will initially invest $2.5 million in the fund, with individual investments of as much as $250,000. The fund will syndicate alongside Elevate Ventures’ direct investment and other venture funds. This new fund will provide capital for diverse founders and/or those who seek to improve healthcare outcomes or related social impact. Companies must be high-growth Indiana-based companies launching in technology or select healthcare and life sciences sectors that may provide solutions to underserved populations.
Elevate Ventures will source and vet companies for consideration, complete due diligence, and provide investment recommendations to an investment committee composed of representatives from CareSource. Investment decisions will be made by CareSource.
All companies receiving funding through the CareSource Diversity & Social Impact Investment Fund will receive Elevate Ventures portfolio benefits.
The new fund joins other CareSource initiatives supporting Hoosiers. Along with providing comprehensive health care coverage and options for the uninsured, CareSource launched a $6 million commitment to invest in affordable housing and partnered with IU Health to offer a virtual care program for students with mental health concerns.
Companies interested in being considered for investment can apply to Elevate Ventures under its “direct investment” application at www.elevateventures.com/apply.
Centene has partnered with the YWCA USA to deploy Young Women Choosing Action, an innovative program designed to engage 13 to 19-year-old girls from low-income families, especially individuals of color, over the course of three years.
Funded by a grant from Centene, this program will help participants understand the impacts of trauma, develop healthy reactions and healthy relationship-building skills, learn effective wellness practices, and grow their leadership and social justice skills. The program was piloted with participants in 24 cohorts over two years at four local YWCA affiliates, including YWCA Brooklyn (NY), YWCA Northwest Ohio, YWCA Northwest Louisiana, and YWCA Watsonville (CA).
Centene Corporation through its foundation, the Centene Charitable Foundation, has pledged to match the first $1 million in corporate donations to the Hispanic Family Equity Fund. The fund, which was launched by the Healthy Americas Foundation (HAF), the supporting organization of the National Alliance for Hispanic Health, aims to support Hispanic families in the post-pandemic recovery.
Michael Neidorff, Centene President and CEO, and Marcela Manjarrez Hawn, Centene Senior Vice President and Chief Communications Officer, issued a call to Fortune 1000 companies and other corporations and foundations to contribute to the initiative and help play an active role in reducing systemic inequities that have challenged the Hispanic community.
The fund includes three components:
- $20 million in immediate equity grants to leading community-based organizations to support community family services. The grants will be used to facilitate the hiring of community navigators who will help close the gap in utilization of early education, childcare, food security, health insurance, economic support, and job training.
- $5 million to monitor national, state, and community policies for recovery from the impacts of the COVID-19 pandemic and ensure those policies serve Hispanic families.
- $75 million as a standing fund to support emerging opportunities and foster innovation in the delivery of services to close the well-being gap for Hispanic families.
The fund’s launch comes at a time when less than 2 percent of philanthropic dollars are invested in Hispanic-serving organizations. Now, as Hispanic Americans face disproportionate negative health and economic impacts of the COVID-19 pandemic, there is an urgent need to address longstanding inequities.
Centene remains committed to increasing diversity within its own workplace. Sixteen percent of Centene employees are Hispanic or Latino, and Hispanic employees represent 12 percent of Supervisor and above leadership roles throughout the company. Centene has Hispanic representation at the highest levels including on the Board of Directors, the C-suite, the Centene Health Equity and Wellness Council and the Centene Health Policy Advisory Council. In addition, our Health Equity and Wellness Council and Health Policy Advisory Council provide critical counsel on how Centene can best support underserved communities nationwide. Centene currently serves a population that is 27 percent Hispanic.
The Hispanic Family Equity Fund is one of several efforts that both Centene and the Centene Charitable Foundation are engaged in to support diverse communities. In June 2020, Centene Corporation and the National Minority Quality Forum (NMQF), an independent research organization dedicated to ensuring high-risk racial and ethnic populations receive optimal healthcare, announced a research partnership for the “Minority and Rural Coronavirus Insights Study (MRCIS)” to assess the impact of COVID-19 on racial minorities and underserved communities across the country. Through the partnership, Centene, NMQF, and a range of other public and private healthcare entities including Quest Diagnostics, came together to conduct COVID-19 PCR testing (to confirm current COVID-19 infection) and antibody testing (to confirm previous COVID-19 infection) at Federally Qualified Health Centers (FQHCs) in California, Florida, Illinois, Louisiana, and Ohio, and 38% of enrollees in the study identified as Hispanic or Latino. In addition, Centene has a long-standing strategic partnership with the National Hispanic Medical Association.
Cigna recently piloted a two-touch campaign to improve breast cancer screening rates among Latina women in California and Latina and African American/Black women in Texas. The two-touch method strategy involved:
- Touch 1, General Education: Cigna published a Customer Engagement Newsletter article, “General Preventive Care/Health Awareness,” with a focus on the importance of annual check-ups and reminders to schedule one.
- Touch 2, Targeted Follow Up: Promoting Breast Cancer Screening Awareness Focusing on the two geographic areas and two demographics where underutilization was highest. Cigna pushed out a personalized call to action to get screened and learn the facts about breast cancer.
There was a 15% response rate for breast cancer screenings among those who engaged with the two-touch model – a 2% lift in response compared with customers who only received one touch.
In 2021, the Cigna Foundation plans to award over $3 million in grants as part of its new Health and Well-Being grant program to support non-profits and community organizations focused on improving access to care and eliminating health disparities.
Despite steady improvement in overall health outcomes over the past decade, many under-resourced communities continue to experience substantial health inequities.
The grants will address one or more of the following areas:
- Increased access to health care
- Increased access to primary care
- Increased health literacy, the degree to which an individual has the capacity to obtain, communicate, process, and understand basic health information and services to make appropriate health decisions and follow directions for treatment
The Boston Globe has ranked Commonwealth Care Alliance® number 1 on its list of Top Places to Work; Diversity Edition. This recognition is due to the organization’s commitment to hire talented individuals from diverse backgrounds, including diverse ethnicities and genders, as well as LGBTQ, veterans, and disabled candidates. CCA has also committed to providing extra mentoring and professional development to a top 20 list of high-potential women and people of color, bringing balance and diversity to advancement. Additionally, CCA is committed to diversifying its hiring teams and providing additional comprehensive training.
CVS Health has launched an expansion of Project Health, the company’s no-cost, community-based screening program, which helps people without regular access to health care understand their risk for chronic conditions and connect to free or low-cost providers and services to support their unique health care needs.
As the company begins its 16th year of Project Health events, it will focus on an expansion into 14 new metro markets and the addition of four new mobile units to help bring these health screenings closer to areas of significant need. Between April and December, CVS Health anticipates hosting more than 1,700 Project Health screening events in a total of 32 metro markets across the country. The new metro areas where Project Health will expand include Birmingham, AL; Phoenix, AZ; Jacksonville, Orlando and Tallahassee, FL; Baton Rouge and New Orleans, LA, Jackson, MS; Charlotte, NC; Cleveland, OH; Charleston and Columbia, SC; and Knoxville and Memphis, TN.
Last year, CVS Health made a nearly $600 million commitment to invest in initiatives that address inequality faced by Black people and other disenfranchised communities. This expansion of Project Health is the latest in the company’s efforts to address social determinants of health that exist alongside racial and economic inequities.
CVS Health Foundation announced it has established a five-year, $5 million CVS Health Foundation Health Care Careers Scholarship program, in collaboration with UNCF (United Negro College Fund). Scholarships will be awarded to Black and Latinx students pursuing an academic career in health care. The new scholarship program is part of CVS Health’s nearly $600 million commitment over the next five years to address inequity faced by Black people and other disenfranchised communities.
CVS Health has named Joneigh Khaldun, M.D., MPH, FACEP as Vice President and Chief Health Equity Officer. Dr. Khaldun will lead the strategy to advance health equity for patients, members, providers, customers, and communities served across all lines of the CVS Health business. She and her team will focus on culturally competent care delivery, ensuring it is fully integrated into the design and development of clinical and population health programs, products, services, interactions and communications. She will also work collaboratively with the broader health care system to advance health equity and better support underserved communities.
Inclusion is integral to a thriving society: when diverse businesses thrive, so do the communities where they are located. Yet women, minorities, people with disabilities and members of the LGBTQIA+ community often face barriers and obstacles to founding their own businesses.
To provide these groups with opportunities to learn from others and to access startup capital, Delta Dental has made a $828,000 investment in the Lightship Foundation, an organization dedicated to supporting entrepreneurs from marginalized backgrounds.
The investment from Delta Dental will be used to fund Lightship bootcamps in Detroit, Cleveland, Columbus and Cincinnati this summer and fall, and a Lightship Accelerator in Detroit. Both programs offer education, networking and mentorship opportunities for business founders.
The bootcamps are a free, two-day program providing beginning entrepreneurs with expert advice on sales tactics, legal information, investment readiness, marketing and more. Since 2017, 72 business founders have completed the program, and $100 million has been raised for their businesses.
Lightship Accelerator is free, 12-week program based in Detroit that provides support and business education to women and minority entrepreneurs in technology. Participants in the Accelerator also receive a $250,000 investment from the Lightship Foundation.
The New York Liberty and Empire BlueCross BlueShield announced a partnership designating New York’s largest health insurer as an “Official Partner” of the team, which includes combined efforts to address health inequities and advocacy for women in greater New York communities. The Atlanta Dream, Indiana Fever and Los Angeles Sparks also begin partnerships with Empire’s sister companies in their respective cities.
As part of the Liberty’s multi-year agreement, Empire BlueCross BlueShield will become presenting partner of the New York Liberty’s Women’s Empowerment platform, Breast Health Awareness platform and National Days of Recognition activations, all of which will have an amplified focus on Brooklyn and greater New York City. Empire and the Liberty will also team up to recognize women throughout New York who are making a positive impact in their communities, through the yearlong #ShineLoudSunday social media campaign.
The company’s commitment to addressing long-standing racial and health inequities made this multi-year alignment with these WNBA teams a natural fit. In a truly unique partnership element, whenever the four teams meet during the WNBA season, both teams will come together to host joint community activities that make an impact on health challenges in their respective cities.
Additionally, Empire BlueCross BlueShield will work closely with BSE Global, the Liberty’s parent company, to provide events, initiatives and volunteer opportunities in the local community for the company’s employee resource groups.
A behavioral health program to help child trauma victims. A food pharmacy program that provides prescriptions for healthy food. A cultural and linguistic educational curriculum to enhance medical provider-patient interactions. These are just a few programs in Florida that are sharing more than $11 million in grants from the Florida Blue Foundation to improve food security, mental well-being and health equity.
The Florida Blue Foundation, the philanthropic arm of the state’s Blue Cross Blue Shield plan, announced grants to 29 nonprofits supporting programs that address key drivers of health, many of which have been exposed and exacerbated by the COVID-19 pandemic.
Other examples of the types of programs that earned grants include a mobile pantry to deliver healthy nutritious meals to residents living in food deserts; in-home behavioral health services to help children and families in medically underserved areas; a culturally-tailored telehealth program to address loneliness and isolation in homebound Hispanic adults; and mental health first aid training for a variety of community resources.
Grants are spread out over a three- to four-year period and range from $200,000 to $400,000, allowing organizations and nonprofits time to develop initiatives as they continue working with their clients.
Harvard Pilgrim Health Care announced a new collaboration aimed at improving maternal health and well-being across New England. Through a collaboration with Ariadne Labs and UMass Memorial Health, TeamBirth, a clinically proven care process innovation pioneered by Ariadne Labs will initially launch at UMass Memorial HealthAlliance-Clinton Hospital in Leominster and UMass Memorial Medical Center in Worcester this May. Lessons from this collaboration will be used to establish TeamBirth as a standard of care that benefits people giving birth across New England.
Americans today are 50 percent more likely to die during childbirth than prior generations, showing a continuously rising maternal mortality rate over decades, despite advances in health care. Data also shows that the risk is higher for Black and American Indian/Alaska Native women. Developed by the Delivery Decisions Initiative at Ariadne Labs, TeamBirth aims to improve both safety and dignity in childbirth by structuring the essential information that should be communicated during every labor assessment. During its pilot program, Ariadne Labs reported that 79 percent of TeamBirth patients believed their preferences made a difference in the care they received and 94 percent reported their clinical team talked with them in a way they could understand.
Two primary elements comprise the TeamBirth initiative — efforts to improve communication between the mother, the family, and the clinical care team, which includes a live birth plan, storyboarding and birth plan “huddles” between the clinical team throughout labor; and a pair of decision-making tools aimed at reducing cesarean sections.
UMass Memorial Health facilities include a tertiary care referral center for high risk pregnancies, a level 3 neonatal intensive care unit (NICU) and comprehensive obstetric and gynecologic care. This includes specialty services in gyn oncology, urogynecology, reproductive endocrinology and infertility. A new in vitro fertilization (IVF) center is scheduled to open later this year.
Health Net, in partnership with Physicians for a Healthy California (PHC), launched a seven-part cultural competency education series for providers in California. The comprehensive series focuses on educating local providers on how to deliver culturally competent care in diverse communities. The series will better equip providers to overcome health disparities that are driven by:
- Language barriers
- Misunderstanding of cultural based concepts and practices
- Unconscious bias in healthcare setting
- Lower levels of health literacy
The Health Net-PHC cultural competency provider education series, developed by Health Net’s Health Disparity team, will be released monthly beginning with the topic of cultural awareness. Subsequent months will include topics with a cultural focus on:
- Adverse childhood experiences (ACEs)
- Childhood immunizations
- Women’s preventive care
- Developmental and Physical disabilities
- BIPOC and LGBTQ healthcare
As an organization dedicated to the health and well-being of every person, HealthPartners is committed to building an anti-racist culture.
Created in 2020, the HealthPartners Equity, Inclusion and Anti-Racism Cabinet is accelerating efforts to advance this critical work and is striving to achieve these goals by 2025:
- Increase the racial diversity of leadership team by 100% – from 10% today to 20% by 2025– to match patient and member population.
- Build an anti-racist cultureand deepen a collective understanding of cultural humility – starting with a requirement that all team members complete bias training in 2021.
- Eliminate disparities in maternal and infant care– prenatal, perinatal and early childhood care have a critical impact on the future of both mother and child.
- Eliminate disparities in childhood immunizations – redoubling efforts to reach families and children to protect against preventable illness and disease.
- Accelerate and expand efforts toeliminate disparities in chronic conditions and preventive screenings, including type 2 diabetes and vascular disease; preventive care including breast and colorectal cancer screening, and others; as well as a focus in specialty and hospital care.
Humana is expanding its efforts to combat racial disparities by launching “Louisville Community of Opportunity” in its headquarters city. The initiative is focused on collaboration with new and existing partners to focus on health equity in Louisville’s West End.
Humana has established a dedicated team of associates to work exclusively on the Community of Opportunity effort by partnering and supporting Black-owned businesses and organizations that serve the Black community in Louisville. The program is a part of Humana’s larger efforts to address health equity and health disparities in its hometown and across the other communities Humana serves. In its 60-year history, Humana has supported its corporate hometown through a variety of investments aiming to inspire health and well-being.
In addition to the Community of Opportunity partners, Humana collaborates with several other key organizations in the Louisville area to help make our hometown more inclusive, equitable, and healthier for all. Significant investments include $6.5 million to Louisville Urban League’s Sports and Learning Complex, $1 million to Evolve502 to fund scholarships that make two years of tuition-free postsecondary education available for JCPS graduates, and other investments in initiatives and organizations such as the Future of Work, 21st Century Parks, OneWest, New Directions, Fund for the Arts, Actors Theatre, Dare to Care, New Roots, House of Ruth, Louisville Urban League, The Lee Initiative, and the Community Foundation of Louisville.
Additionally, Humana opened the Jefferson County Public School (JCPS) 360º Student & Family Support Center at the Humana Waterside Building at 101 E. Main St. to provide services such as Non-Traditional Instruction (NTI) 2.0 platform and log-in help, special education assessments/screenings, school choice assistance, translation assistance, and physicals, as well as social supports from the Louisville Metro Office of Resilience and Community Services.
Each of these investments, as well as Humana’s recent naming of Dr. Nwando Olayiwola as Chief Health Equity Officer, is a part of Humana’s goal to promote and ensure that health equity is fully integrated into the design and development of Humana clinical programs, products, services and all member interactions and communications. This enables Humana to work collaboratively with the broader health care community to advance health equity in health care.
To help confront racial health disparities in southeastern Pennsylvania, Independence continues to develop and support localized solutions that help improve maternal health, including working with Project HOME and AmeriHealth Caritas to address significant health disparities experienced in North Philadelphia through the Keystone Connection to Wellness, announced in January 2020. Through this initiative, expectant mothers in North Philadelphia are participating in Project Home’s Centering Pregnancy program – a national, evidence-based maternal health model.
Inland Empire Health Plan (IEHP) continues to partner with community organizations in Riverside and San Bernardino counties to fight for racial equality in the Inland Empire (IE).
The most recent activity includes a $2,000 sponsorship to the Center Against Racism and Trauma’s (CART) first I.E. Antiracist Summit. To help strengthen Black-led and Black-empowering organizations, IEHP has also partnered with Inland Empire Community Foundation, the Black Equity Initiative, and the Inland Empire Funders Alliance providing a $50,000 sponsorship to the Inland Empire Black Equity Fund.
The health plan is taking steps beyond financial support and sponsorship, working with local health and community organizations to host webinars on issues specifically affecting Black and Hispanic communities. In addition, IEHP is committed to supporting equity in all public policies by staying involved and compliant with the state’s upcoming California Advancing and Innovating Medi-Cal Initiative, known as CalAIM.
CalAIM’s multi-year initiative has three main goals: to identify and manage member risk and needs through whole person care approaches and addressing Social Determinants of Health (housing, food insecurity, etc.); to move Medi-Cal to a more consistent and seamless system by reducing complexity and increasing flexibility; and to improve quality outcomes, reduce health disparities and more.
In collaboration with three Inland Empire universities, 50 local medical students were awarded scholarships from Inland Empire Health Plan’s (IEHP) Healthcare Scholarship Fund (HSF), totaling $40 million over the next 5 years. The scholarship helps local students have greater access to medical school education and aims to address the ongoing physician shortage in the region.
IEHP has partnered with University of California, Riverside; California University of Science and Medicine; and Loma Linda University to support, develop and provide needed physicians, specialists and behavioral health practitioners to the Inland Empire, increasing the current ratio of 35 primary care and specialty physicians per 100,000 people in California to the recommended ratio of 60-80 physicians per 100,000 people.
The scholarship’s inaugural cohort brings together a diverse group of students from the Inland Empire. More than 30 recipient students grew up in the Inland Empire and more than 50% are first generation medical students and grew up in low-income households.
Through the scholarship fund, aspiring healthcare professionals will be guided through the system and connected to the health plan’s provider network. This allows students to pursue successful careers in healthcare immediately after graduation to help support the region’s growing population.
Partnering universities facilitate the application process with the contingency that students agree to practice medicine in the Inland Empire for at least five years after graduation.
Kaiser Permanente, the nation’s largest integrated, nonprofit health care organization, is providing financial support to 13 organizations across the United States whose work focuses on ending the generational cycles of trauma caused by structural racism and injustice experienced by Black Americans and other communities of color. This trauma often manifests in situations and actions that hurt children by causing adverse childhood experiences, known as ACEs, which have negative lifelong consequences for health and well-being.
Data from the Centers for Disease Control and Prevention show that at least 38% of children have had at least one adverse childhood experience before the age of 18, impacting children and families across racial, ethnic, and socioeconomic groups. However, Black and Latinx children experience more ACEs than average, with Black children experiencing 11% more ACEs than white children at all income levels. The COVID-19 pandemic’s disproportionate burden on communities of color — including children — may be fueling a future ACEs crisis: Researchers estimate 40,000 children in the United States have lost a parent to COVID-19, and Black children have experienced about 20% of the losses while making up only 14% of the population.
Kaiser Permanente’s support for community-based organizations is part of its commitment of $25 million in grant funding to support racial equity and economic opportunities that will help aid pandemic recovery for the hardest hit communities, including Black, African American, Latinx, and underserved communities. More than $8 million has already been awarded to support programs that address systemic racism or its accompanying trauma on individuals and communities of color.
L.A. Care has issued a Statement of Principles on Social Justice and Systemic Racism.
L.A. Care has not, and will not, ignore the long unresolved issues of racism and inequity that have burdened all BIPOC communities. Actions, not words, are what is needed now. L.A. Care is committed to supporting our employees, members, providers, and the communities in which they all live – to listen to them, learn from them, and take action.
In addition to continuing to listen and learn from our BIPOC employees, members, and providers, L.A. Care has implemented and is actively working on the following and more:
- An Equity Council which will focus on equity issues and topics related to our L.A. Care employees and members and our contracted provider network and vendors.
- Advocacy work for social justice and including these efforts in our policy agenda.
- An Equity and Resilience Initiative that will support community-based organizations working to mitigate the impact of health care inequities among racially marginalized individuals and communities.
- a partnership.
- A partnership with the Los Angeles County Commission on Human Relations
While our organization cannot solve these challenges alone, we are starting with our family of employees, members, providers, and community stakeholders who have shared their perspectives now reflected in this statement. We will look internally to ensure that our own work environment is free of any racism or discrimination. Working together we can aspire to achieve an America that is truly fair, equitable, inclusive, and just – for all.
An aging population, combined with an aging health care workforce and an increase in chronic diseases, is exacerbating the shortage of health care workers that has been a concern for years. L.A. Care Health Plan, the largest publicly operated health plan in the country, is working to get more people into the health careers pipeline. In partnership with Health Career Connection (HCC), the health plan is launching its Health Careers Internship Program. This is a new program in L.A. Care’s Elevating the Safety Net initiative, a five-year, $155 million commitment to address the physician shortage in Los Angeles County.
Over the next three years, this new $800,000 investment will support a total of 96 summer internship positions for college students and recent graduates who are pursuing a career in health, and who have a desire to work in underserved communities. This investment will expand and scale HCC’s pipeline program to recruit and prepare students from underrepresented and low-income backgrounds for health careers.
Over a 10-week period this summer, 34 students from Los Angeles County who come from underrepresented or disadvantaged backgrounds will support various clinical and programmatic activities while interning at L.A. County community clinics, community-based organizations and L.A. Care.
The interns will receive a stipend of up to $4,200, which can be applied to personal expenses and/or future educational endeavors. Interns will also receive post-internship career guidance, health care career pipeline navigation and academic application assistance to support their future endeavors in preparation to work in L.A. County’s safety net.
The National Committee for Quality Assurance (NCQA) has awarded L.A. Care Health Plan a Distinction in Multicultural Health Care. The award is given out every two years, and this is the fifth time L.A. Care, the largest publicly operated plan in the country, has received the honor for its Medi-Cal, Cal MediConnect and L.A. Care Covered product lines.
The NCQA evaluated L.A. Care’s ability to collect race, ethnicity and language data, to provide language assistance to its members, and its responsiveness and sensitivity to its members’ racial, cultural and language differences.
L.A. Care was among seven California health plans to receive the NCQA’s Distinction in Multicultural Health Care award for their various product lines.
James Kyle, L.A. Care’s Medical Director of Quality, Diversity, Equity and Inclusion, has been asked to serve on an advisory committee for a project focused on Medicaid health equity. The State Health Access Data Assistance Center (SHADAC) is launching the project to determine the need for a data dashboard to track indicators of health equity in state Medicaid programs. The project, which will consist of three meetings that run through the spring, will conclude with recommendations regarding: the necessity and feasibility of a Medicaid Equity Dashboard, potential equity measure domains, and initial proposals for new data that are needed to fill existing data gaps to inform and track health equity into the future.
The MolinaCares Accord, with support from Molina Healthcare of Ohio, announced the launch of its Dental Scholarship Program, aimed at increasing access to dental care services among minorities in underserved communities across Ohio.
Access to dental care is a serious issue in low-income and minority communities, with recent research indicating Black adults suffer from untreated dental disease 2 times more frequently when compared with their white counterparts and Hispanic adults are 1 1/2 times more likely than their white counterparts. Unmet dental needs have a profound impact on a person’s health and their economic opportunity, as people in low-income communities are 100 times more likely to experience difficulties doing their job because of oral health conditions, and they are 200 times more likely to have oral pain than those at higher incomes.
As part of this program, starting in fall 2021, The MolinaCares Accord will fund scholarships at the two top dental schools in the state of Ohio for candidates that support diversity. The scholarships represent a $1.4 million investment over four years and will be awarded to one student admitted and enrolled in each of the four School of Dental Medicine class years at both schools. Recipients will be asked to practice dentistry upon graduation in a dental shortage area of Ohio and to serve indigent patients, including through Medicaid.
The MolinaCares Accord, in collaboration with Molina Healthcare of California, has launched its California Equity and Accessibility Initiative with an initial $1.6 million to advance health equity throughout the state. MolinaCares will support Reach Out’s “Mamás y Bebés” program, which provides new and expecting mothers in the Inland Empire with mental health services and support to improve maternal and infant health outcomes. MolinaCares is also collaborating with the California Primary Care Association (CPCA) to develop and launch the Leadership Equity Program (LEP) and will support Transitions Clinic Network (TCN) to engage formerly incarcerated individuals as they reenter their communities, among other initiatives.
Committed to improving maternal health outcomes in Rhode Island, Neighborhood Health Plan of Rhode Island (Neighborhood) has partnered with the Business Innovation Factory (BIF) to bring LunaYou – a first-of-its-kind maternal wellbeing program – to its pregnant members. Developed by BIF to address the maternal health crisis in Rhode Island, LunaYou is a women-centric, empowerment-focused program that supports prenatal and postnatal care. LunaYou is open to all pregnant women, but it is designed to help Black, Indigenous and People of Color (BIPOC) women – who historically have far poorer maternal health outcomes.
Neighborhood has invested in a two-year collaboration with BIF to start LunaYou as a free program to all of its members. Enrolled pregnant members gain access to knowledge and social connections to learn self-advocacy and personal wellbeing skills. The LunaYou program is available to women throughout pregnancy and for three months following the birth of their child. Services include access to the LunaYou mobile platform; a wellbeing coach; a blood pressure cuff and activity tracker; a digital dashboard that tracks seven indicators of maternal wellbeing; and the “LunaYou Mama’s Community”. Through personal journaling, a trusted circle of support, and an engaged community of fellow LunaYou participants, women are empowered to take charge of their pregnancy.
Neighborhood integrated the LunaYou program into Bright Start, the health plan’s established clinical program for pregnant members. Neighborhood’s care management team began recruiting participants for LunaYou in March and to date, 37 members have opted-in to the program.
The United States is facing a maternal health crisis and Rhode Island’s maternal health outcomes reflect national data. Nationally women are 50% more likely to die or experience a serious complication in childbirth than their mothers. Women on Medicaid are significantly more likely to develop life-threatening complications due to pregnancy than women who are privately insured. Black women are three times more likely to die in childbirth than white women are. Black and Latina women experience rising and disproportionately higher rates of premature births than white women.
One of the ways LunaYou empowers women is by enabling them to visualize their own personal wellbeing progress on a mobile dashboard, visible only to the participant, to track seven indicators of maternal wellbeing throughout pregnancy. Those indicators include staying active, getting support from friends and family, increased personal empowerment, managing stress, getting enough sleep, having a healthy heart, and knowing your voice matters.
As the health plan’s first members were pregnant women in RIte Care – Rhode Island’s Medicaid managed care program for pregnant women and low income adults – adding the LunaYou program to Neighborhood’s member benefits made sense to the organization. Additionally, Marino and Dr. Heredia noted that LunaYou aligns naturally with Neighborhood’s goal to apply interventions to social determinants of health (SDOH) indicators to improve medical outcomes.
All of the data captured in the LunaYou dashboard is generated by participants throughout pregnancy. It is collected from personal survey responses, the free blood pressure cuff and the activity tracker provided upon enrollment. To monitor the support its members receive through the LunaYou program,
Neighborhood receives aggregate reports on members’ engagement in the wellbeing components of the program. At the conclusion of Neighborhood’s pilot of LunaYou, the health plan will consider making LunaYou available to all of its members based on measurable improvements in both clinical and maternal health outcomes.
Early feedback from some of Neighborhood’s initial members enrolled in LunaYou is positive, indicating the program may be providing the resources needed to improve maternal health outcomes. Comments from a sampling of participants are included below.
- “This is my first pregnancy and I’m doing this pregnancy alone as a parent. It feels really good to have the additional support.”
- “Tracking my blood pressure is really important to me and LunaYou gives me a peace of mind while pregnant.”
- “I really want to give birth naturally and to stay active while pregnant. LunaYou will help me stay accountable.”
Sentara Healthcare announced a $10 million investment, called the Sentara Healthier Communities Fund, to improve the health of the communities they serve and make a dramatic difference in the lives of patients and neighbors.
The investment will be split into three areas of focus and will enhance capabilities for Sentara’s partner universities and collaboration between the universities, health systems and community partners to improve public health:
- University Grants ($4 million total): $2 million each to support Old Dominion University (ODU) and Norfolk State University (NSU) in pursuit of their goal for the development of a School of Public Health.
- Collaborative Grants (up to $3 million): Support for collaboration between ODU, EVMS and NSU. Grants will be allocated to ODU/EVMS, NSU/EVMS, or all three as they jointly collaborate to address the public health and health inequities in underserved communities.
- Community Grants (up to $3 million): Support for communities and community service entities in regions of Hampton Roads that we serve but are beyond the immediate footprint of ODU, NSU, or EVMS. The intent for this fund allocation is to make public health and health equity improvement grants in cities such as Hampton, Newport News, Williamsburg and Suffolk. These funds will be allocated to community organizations and other partners to work together to address public health and health inequities in underserved communities in these localities.
The following goals are intended to guide the grant recipients in the prioritized use of these funds for the improvement of public health and health inequities in underserved communities:
- Create and enhance capabilities of partner universities to directly impact and improve public health and health equity in underserved communities;
- Promote and enhance the collaboration between ODU, NSU and EVMS;
- Support community organizations to improve public health and health inequities;
- Support efforts to establish a School of Public Health, critical to ensuring vitality of public health in the region; and
- Promote long-term sustainability of public health and health equity activities and funding required to assure continuity of programs.
Recognizing that Minnesota has some of the worst health disparities in the country – especially among Black, Indigenous and people of color (BIPOC) communities – UCare and the Minnesota Medical Association (MMA) have launched a two-year initiative to promote health and racial equity and improve health outcomes in traditionally underserved and diverse populations. The initiative focuses on mitigating physician and other health professional biases as a contributing factor in health outcomes and supports the adoption of an anti-racist culture by Minnesota health care organizations. Its goal is to begin dismantling some of the key elements of structural racism present in Minnesota’s health care system.
Together, the organizations will:
- Develop and disseminate implicit bias and anti-racism educational resources and tools for providers
- Establish and facilitate cross-organizational communication and exchange of health equity initiatives, practices and policies
- Explore and develop community-wide metrics for accountability
- Identify opportunities for the use of restorative justice models to facilitate trust building between BIPOC communities and Minnesota health care organizations
This work comes at a time when Minnesotans from BIPOC communities are experiencing shorter life spans, and higher rates of infant mortality and diseases such as diabetes, heart disease and cancer than their white peers. These racial disparities are rooted in longstanding patterns of bias and discrimination in the health care system, reflecting broader structural racism in our society. In addition to impacting the shared aspiration for better health for all Minnesotans, these inequities have economic consequences on workforces and the affordability of health insurance. For example, a University of Minnesota health disparities study found that preventable deaths caused by racial disparities cost the state from $1.2 to $2.9 billion each year.