Blue Cross and Blue Shield of Minnesota (BCBSMN) took a stance in a recent report on health equity in Minnesota, building upon their existing content and calling attention to health inequity in the state. The report calls out the health disparities that exist despite the state’s above average health outcomes. To many, residence in Minnesota implies better than average health. But a closer look at the data reveals that this is only true for select zip codes. In fact, BCBSMN reported one-third of the counties in Minnesota have fewer than eight physicians per 10,000 residents. This inequity across communities in a state that promotes a cutting-edge healthcare position is finally calling its players to action.
While some Minnesotans directly face the challenges tied to health disparities, all will face the costs – higher health insurance premiums and reduced allocations to other sectors, such as education and the environment. Industry players have begun investing in solutions, but are they set up to successfully measure the outcomes of the dollars spent? Are they prepared to support these investments in the long-term? If these investments yield no tangible return, Minnesota could be left with the appearance of additional costs to the healthcare system sitting on top of existing cost and quality issues.
Amidst all the buzz surrounding healthcare innovation, Minnesota must step back and refine its efforts to ensure that all its residents have the fundamentals.
Health equity means that all people, regardless of the particular communities in which they live, have adequate access to healthcare facilities, products, and services necessary to achieve improved health outcomes. This includes an individual’s ability to enter a healthcare system through typical insurance coverage. Minnesota has an uninsured rate between 3% and 10%, depending on the county. Individuals who are not enrolled in an insurance plan may choose to forgo care, putting those individuals at higher risk for developing costly chronic conditions. This lack of access therefore contributes to the monetary strain associated with health inequity.
Moreover, many non-clinical factors make up an individual’s overall health and wellness and play significant roles in any assessment of health equity. These indirect – and historically overlooked – factors contributing to health status include genetics, individual behavior, economic stability, education, social and community context, and neighborhood environments and are often referred to as the social determinants of health.
Considering the multitude of variables involved, achieving a fair shot at health is much more difficult for those born into Minnesota’s underserved communities. For example, individuals born into communities with lower high-school enrollment and graduation rates often live in more dangerous, less sanitary environments than those born into areas with higher rates. Minnesota has a high school graduation rate (83%) in line with the national average (84%) but rates vary widely at the county level (53% to 97%). Similarly, while Minnesota’s average rate of children in poverty (13%) is lower than national levels (21%), it ranges widely (8%-40%) by county. While the average figures for the social determinants of health imply that Minnesotans are getting a fair shot at health, the broad ranges associated with these figures at a more local level tell a different story.
Unconventional partnerships have introduced new technologies that will make Minnesota’s efforts easier to track, but we cannot underestimate the cultural change that comes with any major technology change.
The increasing digitization of healthcare data is one major way the industry is seeking to address health disparities. In efforts to close gaps and build long-term strategies, players across the industry are seeking tools that track the right data, helping them understand patients’ health behaviors and target their outreach efforts. Forward-thinking organizations are leveraging text and email chat bots to check in with patients between visits, offering self-service cost estimators to help members anticipate out-of-pocket costs, and implementing software platforms that help healthcare organizations find community services, track social determinants, and coordinate referrals. Investment in the right technology affords opportunities for payers and providers to more accurately assess a population’s health status and needs while simultaneously placing useful tools and resources in the hands of patients.
Despite momentum in the right direction, individuals with limited access to care will continue to face challenges if delivery channels change but organizations do not change with them – payers transforming to become member-centric beyond the IT department, for instance. These traditional players will need to affect an internal cultural shift to maintain meaningful partnerships with companies and organizations beyond the typical bounds of healthcare. Efforts from industry players to address health inequities will not fully come to fruition without continuing to accelerate partnerships outside the industry that influence the non-medical, social determinants of health in Minnesota.
West Monroe can help facilitate these meaningful partnerships through collaborations between our healthcare and technology experts and the leveraging of our data analytics, customer experience, and transformation and optimization capabilities.
Natasha Coult is an Experienced Consultant in West Monroe Partners’ Healthcare practice in Minneapolis.
Grace Anderson is a Consultant with the West Monroe Partners Healthcare and Life Sciences (HLS) practice in Minneapolis.
Ben Weir is an Experienced Consultant in West Monroe Partners’ Healthcare practice in Minneapolis.