Regence partners with health care provider to improve care for Latinx members

By Emily E. Smith
October 30, 2023
older person with medical professional

A deep dive into new data surfaced dozens of opportunities for crucial health care interventions for Latinx members. Asante, a Medford-based health care provider, put the findings into action and is now expanding its efforts.

In late 2022, Kimberly Hadeed, a registered nurse and the Oregon clinical transformation advisor for Regence, received an unusual mission.

New data on Regence members covered by Medicare Advantage plans had just come in—it was self-reported data related to race, ethnicity and language. Michael Ann Benchoff, Regence’s assistant director of health equity programs, asked Hadeed to take a close look and determine how Regence might use the data to improve health equity.

The data gave Regence a new window into the health of particular member populations, providing meaningful insight on the experiences of various racial and ethnic groups covered by Regence plans. And the new information soon grew into a pilot program: With a careful analysis of the data, Hadeed would identify care gaps and health risks for a group of members and collaborate with health care providers on how to help these members achieve better health outcomes through culturally informed care.

“As a nurse, I’ve watched people who haven’t gotten the support and education they needed and watched their diseases progress to the point where their quality of life is so poor,” Hadeed says.

In the concept for the pilot program, Hadeed recognized a significant opportunity.

“Seeing the data, I saw the potential: If we get involved now, we might be able to prevent these members from getting to that point,” she says. “That is very motivational for me.” 

After plotting the data on an Oregon map, Hadeed and Benchoff found that a high population of Regence members in Southern Oregon happened to be both Latinx and patients of Asante, a health care provider based in Medford, Oregon, that serves more than 600,000 patients across nine counties in Southern Oregon and Northern California. Knowing Asante’s passion for improving health equity, Hadeed and Benchoff considered the member pool and the health care provider a promising match for the project.

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From her research, Hadeed knew that Latinx individuals are at a higher risk for certain chronic health conditions and are less likely to have preventive screenings, resulting in disproportionate rates of cancer diagnoses. National data show this community faces disparities in diabetes, metabolic health and mental health outcomes. Latinx adults are 70 percent more likely than non-Latinx white adults to be diagnosed with diabetes.

Latinx individuals are also 50 percent less likely to have received mental health treatment compared to non-Latinx whites. Cultural stigma surrounding mental health issues, coupled with limited access to culturally competent mental health services, can lead to untreated conditions, severe health complications and a reduced quality of life.

On top of these disparities, Hadeed found that many Latinx members don’t receive the care they need because of language and cultural barriers.

“It made my heart break that they had so many potential barriers to getting the care they need,” she says.

Program kicks off with clinical analysis of member data

Once the Regence team identified the members—a group of eight, ages 43 to 92—and the health care provider for the pilot program, Hadeed began digging through an immense amount of data for each member and looked at claims that had been submitted over time to identify possible care gaps.

The available claims data on each member was extensive and sometimes murky, but the opportunity for Hadeed remained clear. “I knew when I started reading, I’d have something to offer these members,” she says.

If Hadeed saw, for example, that a member had an elevated blood sugar lab at some point in the past but hadn’t had another lab check in years or hadn’t seen their primary care doctor in a long time, she flagged it. Those lapses could be opportunities for a health care provider to contact the member and encourage them to come in for a checkup and do another screening.

“It was hours—hours and hours—combing through individual claims and looking at what providers had submitted to us in the past,” she says.

In the end, Hadeed found that nearly all the members had varying stages of heart disease. Many had pre-diabetes. Several had depression. Some hadn’t seen their primary care provider recently. Others weren’t filling medications.

Hadeed also made note of any risks she saw related to social determinants of health, which refer to factors such as someone’s economic stability, safe housing, access to quality health care, nutrition, education, neighborhood safety, plus policies, systems, and other forces that can have an effect on health. In the eight members Hadeed researched, every one fell into the highest-risk category on a social determinants of health risk scale.

Health care provider puts findings into action

Following Hadeed’s clinical analysis, she compiled her findings for Asante. Hadeed partnered with Regence associate medical director, Dr. Murtaza Batla, to come up with a list of recommendations—practical steps health care providers could take to make a difference for these eight members and other Latinx individuals.

Batla’s experiences growing up in Pakistan, his medical training and practicing in many underprivileged communities, activated his interest in social determinants of health and shaped his approach to culturally competent care.

With these recommendations, Hadeed says, doctors might be able to make a critical difference in these members’ lives.

Key interventions included offering Spanish-speaking primary care providers to members who preferred one and prioritizing outreach to ensure annual checkups​ were scheduled and attended. Asking patients if they wanted to be paired with a provider who speaks Spanish could result in a better patient-provider relationship and help patients feel more comfortable in seeking the care they need, Hadeed says.

To address socioeconomic disparities, Asante conducted social determinants of health screenings on every member in the pilot group, and Regence facilitated referrals to additional resources. These included supplemental benefit connections, such as personal emergency response devices, palliative care, home health and nutrition.

“Being able to educate our provider partners on those benefits that they can connect our members to is huge,” Hadeed says.

In many cases, providers don’t know the full benefits and resources available to each individual patient because their patients are covered by numerous different insurance plans—each with its own set of benefits. But with Hadeed’s deep knowledge of Regence’s offerings and community resources, she could provide insight that health care providers typically lack.

Asante formed a work group and began putting the interventions into action. Asante and Regence dedicated culturally informed staff to this group, including a quality coordinator, Spanish-speaking nurse and certified diabetic educator. As a result of the partnership, 58 interventions have been completed for the eight members to date​.

Regence and Asante look to deliver culturally competent care to more patients

Based on the initial success of this pilot program, Regence and Asante have already expanded clinical analysis and care outreach to an additional 62 Medicare Advantage members​. The two organizations are also co-authoring a guide for primary care providers on key learnings to deliver culturally competent care to Latinx communities. On the Regence side, the development of the guide is led by membership administrator Tiana Hernandez, who is fluent in Spanish, passionate about community health and contributing her knowledge of Latinx culture.

Asante Hispanic health disparities project
L-R: Tiana Hernandez, membership administrator, Dr. Murtaza Butla, associate medical director and Kimberly Hadeed, clinical transformation advisor at Regence


In the coming year, Hadeed hopes to see the program continue to grow and help organizations bring culturally competent care principles to a wider population.

“This was one of the most rewarding and meaningful pilot projects we have worked on,” says Cassy Leach, registered nurse and director of ambulatory quality and nursing at Asante. “We plan to reproduce and expand on this great work.”

“I think this pilot shows the power of a payer and provider partner relationship coming together,” Hadeed says. “Without each other, you're lacking the full picture. But with each other, we can really build a better, clearer view of somebody, and there's just so much that we can provide to ultimately affect patient outcomes."