How healthcare payers can leverage data-driven insights to advance health equity

How healthcare payers can leverage data-driven insights to advance health equity

Health equity is a persistent challenge in the United States, where certain populations remain overlooked or underserved. Achieving health equity means ensuring that resources and services are accessible and affordable for everyone, regardless of gender, sexual orientation, race, geography, ethnicity, or financial circumstances. When resources or services are out of patients’ reach, certain preventable diseases and conditions ― including diabetes, hypertension, cancer, and obesity ― become more common.

Health equity is important to the overall health of the economy and of the nation: According to research from Suchit Arora and Robert W. Fogel, healthcare improvements in the last century have accounted for one-third of the economic growth of developed nations.

Medical care determines only some of the factors that impact the health outcomes of populations. The remaining factors are social, economic, environmental, and behavioral. These are often referred to as Social Determinants of Health or SDoH.

These determinants often go unmarked, as only 25% of U.S. hospitals screen patients for SDoH. In 2021, a survey by the Institute for Healthcare Improvement (IHI) indicated that health equity was a major priority for providers. 

The federal government is stepping in, too. New federal measures include the expansion of Medicaid home-based and community-based services, a bigger focus on rural health services, and investments in the treatment and prevention of infectious diseases. Additionally, the Centers for Medicare and Medicaid Services (CMS) recently introduced the Health Equity Index to the Medicare Advantage (MA) Star Ratings system, thus underscoring its own investment in health equity.

Data-driven insights can pinpoint where disparities persist, and technology enablers can accelerate solutions.  These technologies include the use of real-world evidence and real-world data, responsible AI practices, telehealth, apps, and smart devices. Together, these enablers create a seamless data flow; unearth patterns and insights within data; act without biases and enhance clinical decisions; and promote care adherence at a lower cost.