Challenges to addressing health equity

CVS Health and Kroger Health call upon the industry to become data-driven to help expand and implement initiatives to achieve health equity.
Mark Hamstra

Improving health equity will require collaboration among a broad range of partners, including drug store operators, said Dr. Joneigh Khaldun, VP and chief health equity officer, CVS Health.

“The inequities that we see across the country were created over multiple centuries, and involve not just the healthcare system, but also education, housing, transportation and other sectors that are crucial to people being able to live prosperous, healthy lives,” she said. “That means that efforts to address health equity are not simple, easy fixes, and will take time and intentional, prolonged effort and collaboration to achieve success.”

“By focusing on being data-driven, expanding and implementing initiatives that are evidence-based, and centering the voices and experiences of those who have been historically marginalized, we are confident we can collectively make progress in achieving health equity across the country,” Khaldun said.

[Read more: Watch DSN: CVS Health's Community Equity Alliance addresses health care disparities]

Jim Kirby, chief commercial officer, Kroger Health, meanwhile, said creating awareness around the robust suite of health services that Kroger offers has been one of the key challenges the company has faced. To help generate more awareness, the retailer recently launched a brand campaign, called “a world of care is in store” to highlight services such as its tele-nutrition counseling.

Last year, Kroger collaborated with other organizations to discuss solutions to combat hunger, poor nutrition and diet-related diseases at the White House Conference on Hunger, Nutrition and Health. The company committed, in partnership with the American Heart Association and Rockefeller Foundation, to mobilize $250 million to build a national “Food as Medicine” research initiative, Kirby said.

“Additionally, through our collaborations with health systems across the country, we can nimbly work to optimize the patient experience to improve healthcare delivery and maintain continuity of care while expanding the frontiers of care and treatment,” he said.

Measurement Important to Gauge Health Equity Success

Measuring the outcomes of health equity initiatives is key, and is one of the core pillars of the health equity strategy at CVS, said Khaldun.

“We have created robust internal health equity dashboards that provide a unique understanding of quality metrics across race, ethnicity, gender, geography, and social risk factors,” she said. “We leverage these tools to build, improve and align our programs and services based on our customer and patient needs.”

For example, the company’s Healthcare Effectiveness Data and Information Set health equity dashboard measures and evaluates demographic and geographic factors influencing performance on more than 30 National Committee for Quality Assurance-defined healthcare quality metrics.

“This tool helps us identify populations and neighborhoods across the country with the greatest opportunities to address disparities and helps inform content development for member outreach programs,” Khaldun said.

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In a recent report on health equity in the pharmacy space, research firm Deloitte cited measurement as “step one” in beginning to understand disparities and biases.

For example, companies can consider tracking medication adherence by ethnicity, and looking at prior authorization approval rates by gender, and whether patients request prior authorization at different rates based on income, gender, sexual preference or other factors.

“Once you have the data, you can begin to understand the root cause of the issue,” Deloitte said in the report.

Once a company has data and understands the root causes, the company said, “it’s important to set bold goals and align the organization to achieve them.”

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