Disparities in health care Featured

2:21am EDT November 1, 2005
The population of racial and ethnic minorities in the United States is larger than ever, and is continuing to grow at a rapid pace. This demographic change is reshaping the American work force and, as a result, is having a profound impact on the health-related benefits companies offer their employees.

This may seem surprising, because employer-sponsored medical plans often have built-in flexibility to meet diverse needs. Employees can choose their coverage plans, doctors and other plan dimensions. In fact, with new consumer-directed products, employees have unprecedented freedom to tailor a plan to their needs.

Studies show that despite this flexibility, racial and ethnic minorities as a group have less-favorable health care outcomes than nonminorities, even when insurance status, income, age and severity of conditions are comparable. [See "Disparities in health care: facts you should know"].

It also appears that employees do not access health care services in uniform ways. Fortunately, government agencies, civic groups and health plans are analyzing the issues that contribute to these disparities, and are striving to close the gaps in our health care system.

Effect on employers
Meanwhile, even if employers fund medical benefits equally for all their employees, some employees are likely to be underserved when they access the health care system. This can boost claim costs, such as when untreated minor illnesses become more serious, and create a work environment challenged by absenteeism, disability and lost talent.

Fortunately, health plans are offering employers a number of methods for achieving more consistent and appropriate health plan utilization by all employees.

  • Disease management programs. Health plans may have targeted prevention programs for conditions such as asthma, diabetes or heart-related diseases to reach higher-risk groups through foreign-language videos, Web sites and other resources.

  • Targeted education programs. Statistics show that African-American women experience consistently higher rates of premature births. Health plans may provide education about preterm labor, followed up by telephone calls and outreach services.

  • Screening reminders and programs. Hispanic and African-American women encounter barriers to getting annual mammogram screenings, which may lead to higher breast cancer mortality rates. Health plans may be able to reach out to those who have not been screened and provide breast self-examination materials or videos.

  • Spanish-language resources. Health plans should provide enrollment and plan brochures, claim information and other tools in Spanish. Some insurers may also provide Spanish-speaking nurses for 24-hour information, as well as online tools and disease management materials in Spanish.

  • Online self-assessment tools. Some health insurers offer sophisticated Web resources that enable employees to input health information and receive tailored assessments of their health risks. Based on these assessments, they may receive targeted educational materials and outreach services.

The National Business Group on Health also lists concrete steps companies can take to help reduce disparities. (Source: Why Companies are Making Health Disparities their Business: The Business Case and Practical Strategies, December 2003.)

  • At renewal meetings with health plans, ask about their initiatives to reduce health disparities; use the responses as criteria for renewal

  • Establish a quality measurement around reducing health disparities

  • Provide employees with information about appropriate health care services that are evidence-based and useful to all patients

  • Ask employees about their experiences communicating with health care providers and use the feedback as criteria for your health plan renewal

  • Launch culturally and linguistically competent health and wellness programs at the worksite
  • Develop and disseminate culturally and linguistically competent education materials that raise awareness of health issues that disproportionately affect minorities

Which of these programs and ideas will help your organization more ably address the issue of health disparities? It's a question you should address with your health plan provider and your human resources team. With some modest efforts, you will be on your way to providing access to high-quality and highly accessible health care resources for your employees and their families.

THOMAS J. SCURFIELD is vice president of sales and service for the Aetna’s north central east region and is based in Cleveland. He has more than 25 years of experience working in employee benefits and holds both the Chartered Life Underwriter and Certified Employee Benefit Specialist designations. Reach him at (330) 659-8020 or ScurfieldT@aetna.com.