Racial inequity is one of the most intractable problems that exist in American healthcare today. Providers and payers are increasingly focused on finding lasting solutions, especially amid a pandemic that has laid bare the extent of the problem.
The latest advancement in the effort is Blue Cross Blue Shield Association’s new national health equity strategy, announced Tuesday, which aims to mitigate widening disparities in care.
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The association — a national federation of 35 independent and locally operated Blue Cross and Blue Shield companies — will focus on four conditions that disproportionately affect communities of color: maternal health, behavioral health, diabetes and cardiovascular conditions, said Maureen Sullivan, chief strategy and innovation officer for BCBSA, in an email.
The equity strategy will include collecting data to measure disparities, scaling effective programs, working with providers to improve outcomes and address unconscious bias, partnering with community-based organizations and influencing policy decisions at the state and federal levels.
The first goal BCBSA has set is to reduce racial disparities in maternal health by 50% in five years.
“We decided to start with maternal health due to the scale of the crisis,” Sullivan said. “The U.S. has the highest maternal death rate of any developed country and the subsequent gap in maternal health equities between white women and women of color, especially Black women, is extreme.”
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Black women have a pregnancy-related death rate of 40.8 per 100,000 live births, as compared with white women, who have a rate of 12.7 per 100,000 live births, according to a Kaiser Family Foundation analysis. American Indian and Alaska Native women also have pregnancy-related death rates that are much higher than white women at 29.7 per 100,000 live births.
To track its progress toward its maternal health goal, BCBSA will use several national measurement metrics, including the Centers for Disease Control and Prevention’s Severe Maternal Morbidity measures.
Metrics and data will play a key role in BCBSA’s national health equity strategy in general.
“We are consulting multiple experts and working with many local community leaders and providers to determine how best to collect data,” Sullivan said. “We’ll be using the data to measure disparities, improve outcomes and address unconscious bias because…data is crucial to know where we are and what progress we’re making.”
The metrics used will also be reviewed by a national advisory panel that BCBSA has convened, which is comprised of doctors, public health experts and community leaders, she said. The panel will meet three to four times per year.
Aside from the focus on data, BCBSA will lean on community partnerships to achieve its health equity goals.
BCBS companies currently have several partnerships supporting maternal health. For example, Blue Cross and Blue Shield of Illinois teamed up with Centering Healthcare Institute, a nonprofit focused on delivering better health outcomes, to bring its pregnancy program to several federally qualified health centers.
“Our deep roots in the local communities we serve, combined with the scale and scope of our national reach, enable all of us at Blue Cross Blue Shield companies to drive this new strategy and bring real change,” said Kim Keck, president and CEO of BCBSA, in a news release.
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