Company links cultural competency, clinical outcomes to create care navigation ‘communities’

A virtual care company is looking to distinguish itself in a crowded market by rolling out concierge services for communities that face high levels of discrimination in healthcare.

Months after care navigation company Grand Rounds and telehealth provider Doctors on Demand announced plans to merge, the combined entity acquired Included Health and later adopted its name.

That latter decision underscores how important the Included Health division is to the parent company’s business plans. The former startup now operates as the company’s “communities” division, which partners with employers to manage health benefits for special populations within their workforces. Its flagship offering caters to the LGBTQ community and the company plans to debut a program for Black employees later this year. The Included Health unit’s services can work in conjunction with Grand Rounds and Doctors on Demand offerings.

Included Health uses algorithms to match patients with providers that score high on its clinical and cultural competency metrics. The company rates clinicians on factors such as their ability to understand pronouns, the frequency with which they see LGBTQ patients and their experience with interventions such as hormone therapy and gender-affirming surgery. In addition, the company uses the Doctors on Demand telehealth network to facilitate access in areas with provider shortages.

The communities division partners with human resource departments to provide lifestyle and wellness resources for LGBTQ employees and their families, such as how to come out among peer groups or how to support family members who identify as LGBTQ. Employees may remain anonymous to protect those who may not be out in their workplaces, said Colin Quinn, Included Health’s president of health communities.

The navigation team is led mainly by queer and transgender people, and more than 90% of the care team identifies as LGBTQ, Quinn said.

“It’s really helpful whenever you’re talking to somebody who has lived a day in the life or shared in those similar experiences,” Quinn said. “Oftentimes, our care coordinators have already been through many of the challenges that our members are going to be calling about.”

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Included Health is developing a product for Black employees along with clients such as Accenture, BestBuy, Genentech, Medtronic, State Farm, Target and Walmart. Included Health works directly with those firms’ employees to design the service.

The pitch to employers is that engaging marginalized communities can lead to better clinical outcomes and thus lower health benefit expenses.

Included Health surveyed LGBTQ employees working for 10 of its clients in 2020. Forty percent said they confronted discrimination while seeking healthcare and 35% said they postpone or avoid care out of fear of discrimination. Another 45% reported difficulty finding primary-care doctors and 60% said they struggle to find mental health providers.

“It’s really important to open the eyes of employers that a one-size-fits-all approach to healthcare does not work,” Quinn said. “Being able to have that conversation with employers to really ensure they are aware that there are subgroups within their workforce that aren’t accessing the benefits, that just because the benefit is in place does not mean the employee can take advantage of it.”

A report by consulting giant McKinsey found that pay parity among employees does not alone promote equitable outcomes and that employers “need to look for new ways to bridge health disparities beyond just pay.”

McKinsey surveyed workers and found that Black employees who reported a household income of less than $100,000 were more likely to face inequities that impacted their health than similarly situated white employees. An Asian woman reported visiting a doctor who invalidated her health issues after asserting “Asian women don’t have a high pain tolerance’’ and an LGBTQ employee said she was searching for a doctor who wouldn’t assume her child has a dad.

The study proposed investing in care coordination services that help employees find clinicians better suited to their social, economic and physical needs. McKinsey also identified telemedicine as a key tool to bolster access to clinicians.

“Employers have a meaningful role to play in improving the health and well-being of their employees,” the report says. “While health equity is first and foremost a human issue, employers that improve access to healthcare for all employees have the opportunity to make real improvements to both employee health and company performance.”