health equity: a core component of …...health equity: a core component of highmark’s quality...
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HEALTH EQUITY: A CORE COMPONENT OFHIGHMARK’S QUALITY PROGRAM
APRIL 7, 2014
U.S. CHAMBER OF COMMERCE
RHONDA MOORE JOHNSON, MD, MPH
SENIOR MEDICAL DIRECTOR
HEALTH EQUITY & QUALITY SERVICES
HIGHMARK INC
CONFIDENTIAL & PROPRIETARY INFORMATION. UNAUTHORIZED COPYING AND DISTRIBUTION IS PROHIBITEDWITHOUT PRIOR WRITTEN CONSENT FROM HEALTH EQUITY & QUALITY SERVICES (HEQS) DEPARTMENT
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RISING HEALTH CARE COSTS
QUALITY IMPROVEMENT
PATIENT SAFETY
EMPLOYER RFI’s/RFP’s
NATIONAL PRIORITY
ACCREDITATION
HEALTH CARE REFORM
MEMBERSHIP GROWTH
MARKET SEGMENTATION
CMS & VALUE BASED PAYMENT
SOCIAL MISSION ALIGNMENT
EXTERNAL RELATIONSHIPS
REDUCING HEALTHCARE DISPARITIES
AND IMPROVINGHEALTH
OUTCOMES
THE BUSINESS CASE FOR ADDRESSING HEALTHEQUITY
Highmark Proprietary & Confidential 3
A HEALTH EQUITY ROADMAP FOR HEALTH PLANSThis roadmap provides a framework for core areas of focus
MEMBER PROVIDER HEALTH PLAN
• Monitor ExperienceIdentify & Address Gaps
• Collect & AnalyzeMembership Race,Ethnicity & LanguageData
• Develop Culturally &LinguisticallyAppropriate EducationalOutreach &Interventions
• Promote Member &Consumer EngagementLanguage in HealthCare & Wellness
• Identify KnowledgeGaps & CreateAwareness
• Create CulturallyCompetent Interactions& Promote LanguageAccess
• Collect Data & MeasureClinical Outcomes byR/ E/ L
• Reward, Recognize,Realign Incentives forImproved Quality
• Analyze MarketDemographics &Emerging Trends
• Form a multi-disciplinaryteam
• Define Process,Resources
• Promote Awareness &Develop CulturallyCompetent Workforce
• Community Partnerships
• Integration into all PlanBAU & Strategic Initiatives
Requires Senior Leadership Sponsorship,& Systematic Integration at Multiple Levels
AT HIGHMARK INC: HEALTH EQUITY IS INTEGRALTO OUR CORPORATE QUALITY PROGRAM
• The Quality Program provides the infrastructure necessary to improve the quality andsafety of clinical care and services provided to members
• A dedicated area within the Quality Program infrastructure, Health Equity & QualityServices (HEQS), leads the enterprise efforts to reduce disparities, improve the delivery ofculturally and linguistically appropriate services (CLAS) and improve health literacy
• HEQS actions are comprehensive and impact Highmark members, providers, employees,and surrounding communities
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“BEST IN CLASS” RECOGNITION
National Business Group on Health
• March 2013
• National recognition for work to reduce healthcare disparities, specifically among our ownemployees and with our client groups.
• Only Blue Plan in the country to be honored
National Committee for Quality Assurance
• 2011 – First Blue Cross and Blue Shield Plan
• 2013 – Renewed Distinction for all PA products
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HEQS 2014 OBJECTIVES ARE PART OF THECORPORATE QUALITY PROGRAM GOALS
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Objective #3
Objective #5
Objective #4
Objective #6
Objective #2
Identify, analyze, select, and prioritize potential health care disparities and implement targetedinterventions and practices that shape consumer behaviors to improve health and wellness
Identify gaps in care based on member race, ethnicity, and language and develop strategiesto reduce health care disparities through education, resource support, and communitypartnerships
Increase utilization of language access services at network provider practices
Increase the percentage of direct data on file for member race, ethnicity, language preferenceand education level by 3% and increase the percentage of provider race and ethnicity on fileby 10%
Promote health literacy and use of plain language concepts throughout the membership,workforce and practitioner network(s)
Provide information, training, and tools to organizational staffand practitioners to support culturally appropriate care
Objective #1
Key Initiatives
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COLLECTION OF MEMBER RACE, ETHNICITY,LANGUAGE & EDUCATION DATA
2006
2009
• 2011
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CLOSING THE GAP: SELECTED 2013 OUTCOMES
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Disparity Intervention (HEDIS® Measure) OutcomeAdult Access to Primary Care:
• Mailing to African American & Asian Members
30% of those who received mailing had the exam
Breast Cancer Screening (Mammogram):
• English and Bilingual Mailing to African American &
Hispanic Women
15% of those who received mailing had a
mammogram
Colorectal Cancer Screening:
• Bilingual Mailing to Hispanic Adults
6% of those who received mailing had screening
for colorectal cancer
Diabetic Eye Exam:
• English and Bilingual Mailing to African American,
Hispanic and Native American members
13% of those who received mailing had a dilated
eye exam
Children’s Access to Primary Care (0-6 years):
• English and Bilingual Mailing to African American,
Asian, Native American & Hispanic Members
48% of children (0-6 years) who received mailing
had a preventive exam
Children & Adolescent Access to Primary Care &
Adolescent Immunizations (7-18 years):
• English and Bilingual Mailing to African American,
Asian,& Hispanic Members
40% of children and adolescents who received
mailing had a preventive exam and/or immunization
IMPROVED INFLUENZA VACCINATION RATES
2012 – 2013 Flu Vaccine Outreach to African Americanand Hispanic members
2012 Intervention:
• A flu mailing was sent in October, 2012 to commercial members
who were African American and Hispanic who had no claims for fluvaccine for the previous flu season. Members were ages 50 andolder
2012 – 2013 Flu Season Results for those who received the mailing:
• African American: 13.2% overall improvement in flu immunizationrates
• Hispanics: 8.8% overall improvement in flu immunization
rates
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HEALTH LITERACY EFFORTS
Health Literacy educational outreach:
• Articles in Provider Communications
• Continuing Medical Education training
• Over 30,000 “Tips Booklets” distributed
• “Tips Booklets” available in English,Spanish, Arabic, Chinese, French/HaitianCreole, Italian, Persian/Farsi, Russian andVietnamese
• Encourage consumers to ask questions &prepare for visit to their doctor
• “What are the top three questions you wantto be sure to ask your doctor?”
• Guidance on what to do before, during andafter the doctor’s visit
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GREATER PITTSBURGH REGION FAITH BASEDLEARNING COLLABORATIVE, “TAKE CARE OF MYHEART”
• HEQS engaged 30 African American churches
in western Pennsylvania in a “healthy heart”
educational learning collaborative addressing
cardiovascular disparities, one of the leading
causes of death of African Americans
• Churches were recruited from existing
relationships and ‘word of mouth’
• Over 200 church representatives attended
monthly meetings (conference calls,
in person meetings)
• 15 churches completed final reports
• 8 churches turned in evaluation forms
completed by congregants
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MEDIA OUTREACHFacebook
Billboards
Outdoor
Digital ads & articles
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Print & Online Media
Provider communications
Cultural competency training
Monitor network diversity
Practitioner advisory committees
Provider payment activities
Demonstrating plan quality
Provider directories
Language access services
HEALTH EQUITY ALIGNMENT WITH NETWORKMANAGEMENT ACTIVITIES
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