Reengineering the health system to be more DEI-friendly
Creating more equitable health care starts with a better understanding of health disparities and the development of innovative solutions that aim to drive sustainable change.
For many years, employers have been working to infuse Diversity, Equity and Inclusion (DEI) into their business practices, policies and employee culture. Establishing employee resource groups (ERGs), rightsizing hiring practices and offering more holistic and inclusive benefits are all ways businesses have demonstrated a commitment to DEI. But driving sustainable change can take years — even decades — to accomplish.
The same can be said for DEI in health care. Deeper analysis has revealed that the disparities experienced among different communities and populations have underscored the long-rooted inequities that exist within today’s health system.
Reports have shown, for instance, that Black women have higher maternal mortality rates when compared to women of different racial and ethnic backgrounds;1 members of the LGBTQ+ community are more likely to report negative provider experiences and higher rates of mental health issues than non-LGBTQ+ individuals;2 and people who are less financially stable3 or who have less education4 than others tend to have worse health outcomes.
According to a 2022 Deloitte analysis, these health inequities cost approximately $320B annually today and could exceed $1T by 2040 if they go unaddressed.5 That cost to employers can equate to $93B in excess medical costs and $42B in lost productivity.6
"We can’t boil the ocean and solve everything at once, but we can help our members by taking one step at a time."
As a result, much of the health care industry is focused on developing targeted solutions that aim to fix the cracks and lay the foundation for a more equitable health system of the future.
Identifying and understanding the drivers of health disparities
Understanding which factors influence an employee’s health status can enable more proactive intervention and innovative solutions. That’s why teams like Craig Kurtzweil’s are so critical.
As chief data and analytics officer for UnitedHealthcare Employer & Individual, Kurtzweil and his team leverage the world’s largest database of private health care data — second only to the Centers for Medicare and Medicaid Services (CMS) — to understand how different employee groups, as well as the various segments within those employee groups, use the health system.7 This includes insights derived from 1T health transactions, 222M patient visits, 23M+ lab services, 3.8M+ urgent care visits and more each year.7 Kurtzweil’s team then takes that data and analyzes it to spot patterns and trends that may help drive future action and innovation.
“The closer we are to the data, the closer we are to uncovering the factors that may be driving poor health outcomes and the disparities we tend to see within certain populations,” Kurtzweil says. “This analysis helps lay the groundwork for other teams to develop innovative solutions.”
Dr. Cyrus Batheja, national vice president of enterprise transformation and strategic solutions for UnitedHealthcare, explains how his team uses this data and analysis: “After analyzing claims data for ER use, hospitalizations and lengths of stay, we were able to identify populations that might be struggling with health-related social needs, including hunger, safety or homelessness. That data then helped us find areas of opportunity where employers could better support those employees.”
In addition to the nearly 25,000 employees working in data and analytics, insights and data science across the organization, UnitedHealth Group and its businesses — UnitedHealthcare and Optum — leverage information from both internal and external data sources.
For instance, America’s Health Rankings®, a United Health Foundation data platform, is the longest-running state-by-state analysis of the nation’s health, which provides actionable, data-driven insights across 340 health measures to help inform public policy, research and news reporting. UnitedHealthcare also collaborates with community-based organizations, health systems, providers, academia and employers to learn from what they’re seeing within the populations they serve.
"This is the future of health care. We’re using a whole-person approach to care for each member, which includes understanding their social needs and their life experiences. We know broader understanding is ultimately the key to putting members first and improving well-being."
Developing tools and solutions that enable more equitable health care
The data analysis available on health disparities and social determinants of health (SDOH) has led to the development of tools and solutions that are designed to help address the factors impacting employee health and well-being. And this innovation is only expected to accelerate as the understanding of health disparities and the focus on DEI in health care increases.
For UnitedHealthcare, this means offering more holistic and inclusive benefits, such as family-friendly benefits and virtual health options to help expand access to care for those who live in rural communities. Adding demographic and DEI-specific designations into provider directories, such as allowing members to search for LGBTQ+-supportive providers, is another way UnitedHealthcare is fostering inclusion and delivering access to equitable care.
UnitedHealthcare is also working with government entities, providers and health systems to develop and expand the codes for the International Classification of Diseases, Tenth Revision (ICD-10), which helps flag members who are experiencing challenges related to SDOH so they can be connected to the right resources and social support.
Employers are taking initiative, too:8
- Around 9 in 10 surveyed employers indicated they are currently or planning on taking action to improve health equity in 2024
- About 30% of surveyed employers reported collecting information on race, gender identity or other demographics to facilitate equity analysis
- About 40% of surveyed employers reported providing equitable familybuilding benefits that support all kinds of families
- Around 4 in 10 surveyed employers reported ensuring their employees could identify providers who are acceptable to them
Investing in the future of health care
On top of innovating and evolving tools and solutions to be more DEI-friendly, UnitedHealthcare recognizes that achieving transformational change and building a more equitable health system requires long-term planning and investment.
The overall health and well-being of a community can represent the strength of an employer’s current workforce and may also predict the health of the potential future workforce. Recognizing this, UnitedHealthcare is working with community-based organizations, local health systems, providers and employers to improve the health of communities across the nation.
- Through its Empowering Health program, UnitedHealthcare has invested more than $62M in grants to community-based organizations across 30 states and the District of Columbia, reaching more than 11M people since 20189
- UnitedHealthcare Catalyst® combines internal analytic insights with community input and experience to create community-based solutions in 28 states across the country
- UnitedHealthcare Communities of Health is a largescale community initiative designed to ensure necessary infrastructures are in place to help achieve health equity
- The UnitedHealth Group Treasury Partnership leads tax credit and social impact investment strategies focused on key areas like health care access and affordable housing, investing nearly $800M since 2011 to help build nearly 19,000 new homes across 27 states and the District of Columbia, and another $90M in other social impact projects, such as building or expanding health centers and improving health outcomes in communities
- The United Health Foundation — established by UnitedHealth Group, the parent company of UnitedHealthcare, is a not-for-profit, private foundation, which has committed more than $700M to improve the health system, build a diverse and dynamic health workforce and enhance the well-being of local communities
It’s also critical to build a diverse pipeline of health care professionals and to ensure the next-generation health care workforce is trained and equipped to deliver care that is inclusive and equitable.
Since 2007, the United Health Foundation has provided more than $25M in funding to support more than 3,300 scholarships for diverse students pursuing careers as primary care health professionals.10 In 2022, the Foundation doubled down by making a 10-year, $100M commitment to deepen and scale its health workforce diversity efforts, with a goal of providing scholarships to and supporting 10,000 underrepresented current and aspiring health care professionals by 2033.10
These innovative efforts and investments have the power to transform the future of health care, and UnitedHealthcare is continually looking at which DEI needs exist, forecasting trends and then developing solutions that matter to employers, their employees and the future workforce.