HealthChangers Podcast: How health equity makes care better for everyone

Main image: Michael Ann Benchoff, assistant director of health equity programs

We have seen an increased focus from many organizations in recent years on diversity, equity and inclusion (DEI). In health care, this has been most visible in the growing momentum in the industry to fight for health equity, to reduce the health disparities that lead to worse health outcomes for underserved communities.

We saw these disparities on display during the pandemic: American Indian and Hispanic people had a higher risk of COVID infection, and American Indian, Hispanic and Black people had a higher risk of hospitalization and death from COVID.

On this episode of the HealthChangers podcast, host Ashley Bach spoke with Michael Ann Benchoff, assistant director of health equity programs at Regence, about why the fight for health equity is so important. We also talked about the work that Regence is doing to make the health care system more inclusive and effective for everyone.

Listen to the full podcast episode on the player above. Below are some highlights, which have been edited for length and clarity.

AB: Why is it so important to focus on health equity?

MB: Health disparities hurt a large part of this country, communities of color, LGBTQ+, rural populations and low-income families, just to name a few. So hundreds of millions of people. And the pandemic highlighted problems that were already there. Communities of color, for example, have long had more barriers to care. Health equity matters because it's good health care. Studies show that up to 80 percent of a person's health outcomes are driven by what are known as social determinants of health. These are the non-medical factors in a person's environment that affect a person's health and wellbeing. It includes nutrition, housing, transportation, employment.

I started out as a social worker. I worked in community health clinics in Portland, Oregon, and had the opportunity to work alongside folks who had a lot of barriers. I saw the tremendous impact of health inequities, on people and communities that I often would think, “this person isn't suffering from their condition; they're suffering from a disparity.”

And I've seen this play out in all of the different roles in health care that I've had--whether it's through a health plan, or in a provider clinic, or doing direct service. This aspect of considering the whole of people, leaning in to what either supports or prevents full engagement in optimizing health is the best path forward. But it also requires a willingness to look at things from a systems perspective, that it's not just on the individual level. And it's not just what happens in the provider setting. This is about how longstanding structural inequities can get in the way and the responsibility to incorporate that into a whole person health assessment, looking at how do you remove barriers that are standing in an individual’s way. And then how do you also look at addressing structural components, so that as a society, we can continue to get better and better.

AB: Health disparities are not just an issue for someone else, if a large part of our country is not able to get the health care they need. These disparities impact everyone, right?

MB: Right. Let's look at this issue from the perspective of an employer, for instance. They care about their employees, and they want to make sure that they have access to affordable, effective care that works for their lives. But this is also about business outcomes. When employees are more sick because they don't have a primary care physician or they don't have a therapist who they can connect with, that hurts the bottom line for their employers. In fact, a recent report showed that health inequities in the U.S. are responsible for $320 billion in annual health care spending. And that number is expected to surpass $1 trillion a year by 2040 if we don't make health care more accessible and effective for everyone. These costs are shouldered by employers, families and communities. We need to make the economic case for addressing health equity, not just the moral case.

AB: What is the reaction from folks when you tell them you work in health equity?

MB: For folks that have more lived experiences with the impact of health inequities, there's a lot of hunger to share, learn more and think about how we can partner up. And for others, it's an opportunity to explore what does it actually mean and dispel some myths.

Health care is something that we all have; it's a shared universal experience. Not one of us is going to get through life not going through an unexpected health journey, or a health challenge. It's an easy access point to empathy, where we really can consider another person's experience and point of view without having direct experience with it. And so the opportunities to create those connection points or learn from others what theirs are, to show that this actually matters for all of us. I do believe that health equity is an all-of-us experience. With those that it impacts directly, we have the opportunity to stand alongside and help find solutions, create more representation, the important process of ensuring more dignity in health care journeys. And then simultaneously, what we can grow and learn as others in helping to plug in solutions that make a difference for all of us.

AB: What is Regence doing to address health disparities for the members we serve?

MB: Our goal in everything we do in health equity is that every person should have the opportunity to live their healthiest life. Two critical ways we do this are through data and relationships. Data is the underpinning of effective health equity programming. So the right member and community data helps us to identify disparities where they may exist, prioritize opportunities, and then importantly, evaluate the effectiveness of our interventions.

For instance, we're using new data to rebuild our provider search capability online, so our members can search for doctors best suited to meet their health care needs and preferences. This includes cultural competence like LGBTQ+-affirming care, language accessibility and culturally specific services. Trust is a key issue in health equity, and for many members, finding a provider whom they see similarities with or who provide tailored care can enable stronger relationships with their health care providers. And this leads to more appropriate care, better health outcomes, especially for members of traditionally underrepresented groups.

We also use our data to find which members or communities may be needing additional or different types of services.

Our work is also about relationships. Employees in our Consejeros program work with Spanish-speaking members to help them understand their benefits and navigate the health care system. It includes a 24/7 hotline. This bilingual bicultural service can strengthen the effectiveness of our relationships with these members so that they can optimize their benefits and resources.

Working with providers in different ways is also critical. Regence has teamed up in certain areas with DispatchHealth, which is a mobile urgent care solution that helps address transportation barriers and unnecessary emergency room visits. This improves affordability for everyone.

We also recognize that to address a crisis like behavioral health, we won't get very far if we don't help health care workers. Working with our philanthropic foundation, Regence is strengthening the health care workforce, especially in behavioral health, by addressing the health needs of workers and investing in training and diversifying the workforce.