Unmet Healthcare Needs: What Employers Can Do to Tackle Health Equity

Everyone deserves the opportunity to live a healthy life, regardless of race, ethnicity or socioeconomic status. By promoting health equity, companies can help improve the overall well-being of their communities.

“If you’re an employer, you want your employees to be in the best possible health because that’s when they’re going to be most productive,” says Lisa Cooper, Professor at Johns Hopkins University in the Schools of Medicine, Nursing and Public Health. “If you want to be seen as a good employer or even as somebody who is a good neighbor within a community, it behooves you to pay attention to what it takes for people to be healthy.”

Many studies show that improving health equity can lead to increased productivity, lower healthcare costs and people living longer and healthier lives. The gains from reducing healthcare disparities are estimated at $135 billion annually. Here are five steps businesses can take to advance health equity in the workplace. 

Expand Benefits 

About 155 million people in 2021, or approximately half of the U.S. population, had employer-sponsored health insurance. But just because your company provides you with health insurance or you have a high salary doesn’t mean you are free from healthcare disparities. 

Women of color and LGBTQ+ employees have the highest share of unmet needs, which can lead to decreased access to healthcare and lower satisfaction with the care they receive from their employers, according to McKinsey & Company research. 

“We know good health includes having a safe place to live, access to nutritious food, enough money to pay the bills, strong social connections, and clean air to breathe — the essentials of life,” says Ronald L. Copeland, MD, Senior Vice President and Chief Equity, Inclusion and Diversity Officer at Kaiser Permanente (a Fair360, formerly DiversityInc Hall of Fame company.) 

“We believe that being healthy isn’t just a result of high-quality medical care – through our resources, reach and collaboration with other nonprofit organizations, we are addressing unmet social needs and factors that impact the health of our communities.”

Cigna (No. 24 Fair360, formerly DiversityInc’s 2022 Top 50 Companies for Diversity list) says responding to those unmet needs can include offering employer-assisted housing programs, flexibility for fully remote or hybrid working arrangements, career training or financial training opportunities. 

With an eye on talent acquisition and worker retention, more companies have provided mental health support, family caregiving, parental leave and other benefits. But Cooper notes that expanding benefits is only one piece of the puzzle. 

“People should be thinking about, first of all, paying wages that will allow people to afford a good quality of life, a type of life where they can be healthy,” she says. “In addition to providing basic health insurance, if possible, provide other ways that people can cover things that are out of pocket.”

Many companies have expanded benefits like flexible spending accounts (FSAs) and high deductible health plans (HDHPs). FSAs are pre-tax benefit accounts that help workers set aside money for out-of-pocket costs, while HDHPs combined with health savings accounts allow people to save for certain medical expenses tax-free. 

Lower Costs 

While companies contribute to the most significant share of employer-sponsored health insurance, consumers need help with what they have to pay, according to Kaiser Family Foundation research. In 2019, individuals paid $1,299 in premiums for single coverage and $5,969 for family coverage.

“If everyone’s paying the same amount for their premium, that means that people that make less money are paying a higher percentage of their take-home pay towards premiums than someone making more money,” says Shantanu Nundy, co-author of an article titled “Employers Can Do More to Advance Health Equity” for the Harvard Business Review and primary care physician and Chief Health Officer at Accolade.

Average deductibles also left middle-income households underinsured and exposed to high out-of-pocket costs, a 2020 Commonwealth Fund survey found. In half of the states in the United States, the median out-of-pocket spending for people with employer-sponsored coverage was $1,000 or more. 

Consumers that can’t afford healthcare are more likely to avoid seeing a doctor when sick, skip a recommended follow-up visit or not fill a much-needed prescription. 

“There are working people who have health insurance, but all health insurance is not the same,” says Cooper. “Some health insurance covers catastrophic illness and things like hospital or emergency room costs, but they don’t cover other things like medications, eyeglasses or dental care and vision care. Things like that cost a lot of money and people have to pay out of pocket because it’s not considered part of their benefits package.”

Health management solutions offered by third-party vendors and health insurers, member advocacy solutions and navigation and health management tools are among the solutions companies have implemented to manage medical costs and improve the member experience. 

READ: The Cost of Getting Sick: Black Americans and Medical Debt

Address the Social Determinants of Health 

Social determinants of health (SDOH) are the non-medical factors that affect people’s health outcomes, like where someone lives or works. Research shows that SDOH disproportionately impacts people of color, especially Black people. 

Medtronic (No. 10 Fair360, formerly DiversityInc’s 2022 Top 50 Companies for Diversity list) believes healthcare technology is a bridge to helping providers identify patients who may benefit from treatment earlier, drive better patient outcomes and help dismantle disparities across the healthcare system.

“We also believe that by combining healthcare technology with community partnerships, we can overcome the barriers facing each unique population and provide sustainable solutions,” says John de Csepel, MD, VP and Chief Medical Officer, Global Regions at Medtronic and Executive Sponsor of the Medtronic Health Equity Advisory Committee. “While technology is critical to advancing health equity solutions, it’s also critical to have on-the-ground collaboration with health systems, governments, NGOs and patients to identify gaps in care and build programs to overcome barriers.” 

People who experience adverse impacts of SDOH are almost two times more likely to have an avoidable emergency room visit and more than one and a half times more likely to have an avoidable inpatient visit, according to 2022 claims data from Cigna.

To address racial disparities in maternal care, Walmart (No. 26 Fair360, formerly DiversityInc’s 2022 Top 50 Companies for Diversity list) expanded its doula services in 2022 beyond Georgia to three additional states: Indiana, Louisiana and Illinois. Kaiser Permanente’s initiatives to improve health equity include $50 million to bolster programs that increase food and nutrition security and improve health outcomes for the country’s most vulnerable populations.

“We continually look for ways we can innovate to address the social drivers of health that lead to poorer health outcomes for communities of color and other traditionally underserved groups,” says Copeland.

READ: Prioritizing the Health and Well-Being of Pregnant Workers

Improve Awareness and Accessibility 

Most participants in employer insurance plans do not open or read benefits materials and almost half of them need help understanding the materials, according to research from the International Foundation of Employee Benefit Plans.

To bridge the understanding gap, employers should ensure that the value of benefits is communicated to employees in simple language throughout the year, not just during open enrollment. Workers can tap into multiple channels like email, materials mailed to their homes and internal websites. 

Businesses can encourage healthy employee behaviors with fitness classes or smoking cessation programs and provide workplace access to preventive care screenings. The adoption of telehealth remains high following the COVID-19 pandemic. Companies can improve employee access to healthcare by delivering virtual primary care and mental health services. 

“If you live in a community that doesn’t have enough doctors with therapists, virtual can overcome that because suddenly you have a doctor anywhere in the country,” says Nundy.

“If you have doctors in your area that you don’t feel like look like you and are like you, you now have access to a much broader list. And finally, it gets rid of that logistical barrier for a lot of people.”

Focus on Data and Research 

Fair360, formerly DiversityInc’s benchmarking services can help companies measure their policies and practices to ensure they are fair and equitable. Measuring the business case of health equity is the first step companies should take to improve the health and well-being of their employees, says Nundy.

“A lot of businesses are putting their heads up and saying, ‘this is a moral or ethical imperative. But if we don’t have a business imperative behind it, then it’s unlikely you’ll be able to make the sustained investments required to meaningfully move this stuff forward.”

Companies also need to understand more about the health status of their communities. All Fair360, formerly DiversityInc’s 2022 Top 50 Companies for Diversity have made specific commitments to address the health and safety of its general workforce in the coming year.

“What are the healthcare costs for certain racial groups or marginalized groups? Or companies get data from their insurance company that say this is how many people did a preventive visit last year. Let’s look at the preventive visits and the mammograms by race, ethnicity or socioeconomic status. Those things create a strong baseline and help you understand where to start first,” says Nundy.

Cooper suggests that companies partner with public health or healthcare experts when collecting data and learn how to serve their employees better. 

“You can’t emphasize enough the importance of being a trustworthy and reliable partner not only to your employees but also to the people and the organizations in the community around you. That’s one of the ways to advance your business but also advance your whole community.”