Photo by Mathias Jensen | Unsplash
As time goes on, an increasing number of business interests in our society are finally understanding that health inequities are not only unacceptable, but also unconscionable. Beyond that, some organizations, including payers like Blue Cross Blue Shield of Massachusetts (BCBSMA), are starting to recognize that pursuing equity can carry important economic benefits.
In 2021, I addressed the role that payers should play in achieving health equity. In the year since, IHI has had the exciting opportunity to partner with BCBSMA to support its direct investment in care delivery systems to help achieve more equitable outcomes. It is the first example I’ve seen of a payer making this kind of commitment at scale — and BCBSMA is doing more than simply providing funding. I hope this bold precedent is one the rest of the industry will take note of and follow.
Equity Report Cards
Many aspects of this program are crucial to building sustainable improvements in equity, but one of the most notable is that it is driven by data. BCBSMA is helping set their health system partners up for long-term success by investing in data that helps identify where equity gaps exist in key performance areas. New data collection systems gather better information from patient populations on race, ethnicity, language, sexual orientation, and gender identity.
BCBSMA team members use this information to create public health equity report cards for some of the largest health systems in Massachusetts, as well as report cards for individual health systems. Individual report cards help organizations understand how they compare on specific measures relative to their peers.
With better and more refined data, providers and payers can see the opportunities for improvement with greater clarity. BCBSMA is also helping 12 Massachusetts health systems make investments in their local environments to tackle the biggest health inequities they are seeing in areas that include diabetes, cardiovascular care, and cancer care.
The BCBSMA work is just one example of collaborative problem-solving, which is part of IHI’s theory for how to accelerate transformation. Before the financial support from BCBSMA became available, IHI brought health systems together through the Pursuing Equity initiative that started in 2017. (The third iteration of Pursuing Equity is free for health systems and is accepting enrollments now.)
This initiative has offered a wide range of lessons related to the role of health care in advancing equity and racial justice, including how to:
- Build equity into an organizational strategy and address the leadership challenges and denial that people often encounter as they start working on health equity
- Stratify data collection and learn from stratified data
- Effectively partner with communities
- Ensure that quality and population health departments are activated around health equity
Every health system encounters challenges like these as it works on health equity. We are not only helping care providers tackle these challenges, but helping them talk to each other about what they’re experiencing and learning, so that they can improve together.
And we’re starting to see some wins. The trajectories of longstanding inequities are now being changed in areas including cancer screenings, stroke care, and diabetes care. Collaborations such as those between BCBSMA; IHI; and others working with communities, individuals with lived experience, the clinician community, and the patient and family communities will help to build a durable solution to these issues going forward.
Editor’s note: Look for more each month from IHI President and CEO Kedar Mate, MD, (@KedarMate) on improvement science, social justice, leadership, and improving health and health care worldwide.
You may also be interested in:
Improving Health Equity: Guidance for Health Care Organizations
Using Quality Improvement to Address Racism