Health outcomes and access to care in the US can vary widely—even for workers employed by the same company and offered the same insurance plans.
These disparities are partly driven by social determinants of health (SDOH), or factors such as geographic location, financial security, and access to food and housing that contribute to health outcomes. With these trends in mind, many employers have started working with their health plans to address health inequities and gaps in care within their employee populations.
For multinational employers, this might look like establishing a global minimum standard so workers receive similar benefits, no matter the country in which they’re based. If companies have employees based across the US, they can dig into data from their insurance partners to better understand how specific populations are utilizing their benefits, experts told Healthcare Brew.
How SDOH factors affect equity. A recent white paper from UnitedHealth Group and the Health Action Council (HAC), a coalition of employers and union groups, found that where US employees are based can have a significant impact on employer health costs.
The study analyzed HAC plan sponsor claims data from 217,779 employees, 66% of whom were based in one of the 20 lowest-ranked states based on 87 health measures identified by UnitedHealth Group’s not-for-profit United Health Foundation. Primary care physician availability, access to broadband internet for virtual care, and prominence of food deserts are all variables that can affect patient health outcomes, Craig Kurtzweil, chief data and analytics officer for UnitedHealthcare Employer & Individual, told Healthcare Brew.
According to the research, employees living in lower-ranked states were more likely to face challenges related to SDOH and incur higher health costs. If that 66% of the population in low-ranking states lived in the top 20 states, however, total covered per member per month (PMPM) costs may have been reduced by $61 million, the study determined.
The white paper also tracked trends by age, finding that younger generations were more likely to have three or more SDOH risks; some 13% of millennials fall into this category, compared to 6% of Baby Boomers.
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What employers can do to improve equity. Employers can start by working with their health plans to analyze insurance data and identify “pockets of the population that are driving some of the risk and cost and utilization,” Kurtzweil said. From there, employers can develop solutions to target members of their workforce who are contributing to these issues, he said. They can consider partnerships with other employers or their health insurance company, for example, to implement these solutions.
A lot of this will come down to education, Kurtzweil added: “Can you engage the population, educate them on the right ways to navigate a very complicated healthcare system?”
Vikki Walton, a health equity leader with consulting firm Mercer, echoed the importance of digging into data to identify and address health disparities within employee populations. If a business sees that they employ, say, workers living in food deserts or low-wage earners working in a call center who can’t regularly see a physician, “then maybe you have a mobile clinic, maybe you look at doing things a little differently to support those populations.”
Walton said most insurance carriers that her organization advises recognize health equity is important, “and it’s becoming increasingly important for the plan sponsors.” Carriers typically have health equity teams standing by to advise employers, whether from a medical or operational perspective. Additional examples of equitable solutions employers may pursue in partnership with their insurer include developing benefit guides for LGBTQ+-identifying employees or covering doulas to mitigate higher rates of maternal mortality in certain populations.
“We just have to make sure that we continue to raise that awareness, we push them for those changes, and incrementally, we’re seeing change over time,” Walton said of employers’ work with insurance carriers.