Significant health inequities continue to persist across California and the entire nation. Health inequities are in large part a result of poverty and an unequal distribution of resources. These inequities take a toll on health as demonstrated by health outcomes that vary by income, education, race, gender, ethnicity, geography and other dimensions of individual and group identity. In California, we pay a high price in lost lives and deteriorating health as disparities continue to widen care gaps. In fact, a recent report commissioned by The Robert Wood Johnson Foundation projected U.S. health costs related to racial health disparities alone to be approximately $337 billion between 2009 and 2018. Findings like this have propelled health equity as a leading priority for states and health organizations, including Anthem Blue Cross Medi-Cal health plan (Anthem), which is fighting to restore health equity.
Anthem understands that strong communities do not just happen. It takes a commitment to deliver on the diverse needs of health plan members, a keen understanding of the connections between an individual’s health and the factors that shape it, as well as strategic collaborations with local and national partners to promote inclusion, improve access to resources and ensure sustainability. For these reasons, Anthem has taken a strategic approach to enhancing its operational infrastructure, increasing its focus on data and promoting innovative clinical programs that increase health equity.
ANTHEM BLUE CROSS INFRASTRUCTURE ENHANCEMENTS
Infrastructure enhancements and leader development play an important role in cultivating the organizational collaboration needed to achieve health equity. Training, professional development and capacity building are what help an organization to navigate through various institutional contexts surrounding health equity. Anthem therefore recently enhanced its infrastructure to build capacity and uniquely position its Medi-Cal health plan to succeed.
Anthem built a Health Equity team within its Quality department that is committed to advancing health equity in Anthem’s programming, partnerships and offerings. Led by a Medical Director and driven by a seasoned Director of Quality and a Health Equity Program Manager, this team engages various Anthem departments to form a Health Equity Council, which reviews existing and new programs through the lens of health equity. The group also involves Case Management Nurses, Quality Specialists, Provider Solutions Managers and more to form relationships with county and community organizations across the state. This allows them to develop effective, local solutions and to more meaningfully engage communities. The time spent developing this infrastructure and maintaining collaborations has been integral to Anthem’s success.
ANTHEM BLUE CROSS FOCUS ON DATA
Anthem uses a holistic approach to create and deliver innovative, data driven and personalized solutions that improve lives. Anthem strives to make informed decisions by using actionable data to understand individual needs, and to then offer treatment and support at the right time and place. Anthem uses a combination of data and technology to connect members with the care they need, and is investing in innovative approaches to simplify care for those who need it most.
Anthem’s enhanced focus on health equity has sharpened its focus on data-driven strategies. Particularly, Anthem focuses on close analysis of member data, such as claims and encounter data, and look for unique markers to better understand needs. Findings, along with insight from community partners, then drive the creation of programs and solutions that ensure access to needed services.
ANTHEM BLUE CROSS CLINICAL PROGRAMS
Healthcare is better when everyone contributes, so Anthem has built relationships with healthcare providers and formed collaborations with local and national partners to make a greater impact on lives. These deep relationships along with engagement in every market served uniquely positions Anthem to advocate for diverse needs and redefine what is possible in terms of health equity. Anthem’s doula pilot program, which has been designed to address disparities among African American women in Fresno County, is just one example.
Fresno County has the second highest preterm birth rate in California, and the preterm birth rate for African American women is 64.6 percent higher than white women according to the March of Dimes. There is a growing consensus that doulas play a vital role in supporting vulnerable communities of color and can have a positive impact in birth outcomes. Research suggests that doulas improve maternal health outcomes through multiple mechanisms, including offering continuity of care, and by helping pregnant women feel empowered to communicate their needs and concerns to their provider. Missed or delayed diagnoses are a leading preventable factor for maternal morbidity and mortality, and doulas have been considered a potential solution for helping mitigate this issue at the provider level.
Anthem has thus joined Fresno County Department of Public Health’s Black Infant Health (BIH) Program and a community-based doula organization to launch a doula program in Fresno County. This program offers education, care coordination and case management, depression screening, referrals for resources (e.g., housing, food insecurity, transportation), and family support. Through this collaboration, Anthem ensures participants have a personal advocate and learn self-advocacy skills to navigate through the complex medical system and beyond – so that they can have a healthy pregnancy. The primary objectives of this program are to reduce the risk of preterm birth and ensure that women attend their prenatal and postpartum visits. Anthem is also part of a larger statewide effort to streamline and standardize data from doula pilots in an effort to collectively impact policy change that promotes health equity.
Other examples of Anthem efforts to promote health equity include a vaccination effort that targets the Bay Area’s Southeast Asian community, which has disproportionately low vaccination rates; a cancer screening effort among Central California’s Hmong community to address high cancer mortality rates; and an effort to deploy hundreds of digital kiosks with live, on-demand interpretation capabilities to address language barriers in primary care centers across the state.
It is through efforts and programs like these that Anthem is empowering more Californians to attain full health potential. And while our state has a long way to go to ensure health equity for all Californians, Anthem is emerging as a leader by tackling some of the most complex disparities and taking action to transform healthcare.