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August 17, 2021 04:00 AM

Three priorities to create a stronger system of health amid and after COVID-19

Dr. Shantanu Agrawal and Bryony Winn
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    Dr. Shantanu Agrawal and Bryony Winn

    Anthem Chief Health Officer Dr. Shantanu Agrawal (left) and Chief Strategy Officer Bryony Winn (right)

    More than a year into a pandemic that has devastated millions, it is understandable to want to race toward the day when this dark chapter of history is behind us and simply move on. But failing to examine this ongoing crisis would be a missed opportunity to better position our healthcare system to tackle future health challenges and work better for everyone.

    While the pandemic hasn’t created new rifts in our system, it clearly exposed them. We need to acknowledge that the healthcare industry and those of us who work within it, have not adequately responded to some of our most pressing health concerns with the urgency they demanded, especially when it comes to serving communities of color. We must seize this moment to realign our healthcare priorities.

    Priority 1: Center equity in every effort to improve health
    We believe that equity is inextricably linked to improving lives and communities. More than that, we know equity cannot happen by accident. Our own research found despite an overall increase in telehealth visits among all racial groups during COVID-19, Black people had 7% fewer in-person and telehealth mental health visits compared to white people with similar demographic, clinical and socioeconomic backgrounds. And additional Anthem research found non-Hispanic Black pregnant women have at least a 20% higher risk for maternal morbidity, including preterm birth, hypertensive disorders of pregnancy, and stillbirth/fetal death, compared to non-Hispanic white women with similar demographics, clinical characteristics, and socioeconomic status.

    Equity must be intentionally incorporated at every level of our healthcare system to address health disparities and social injustices. And we must be strong allies by amplifying every voice in our community.

    Priority 2: Re-orient our healthcare system to promote health rather than provide healthcare
    Helping people be and stay healthy starts with broadening our view of what health means. For too long, health has been regarded as something inherited or predetermined. We have long known that factors like food security, safe housing and reliable transportation account for more than 80% of health outcomes, yet the healthcare system still prioritizes treating illness over addressing health. 

    If we invest more in building health than treating disease, we can improve health in the broadest sense while lowering the cost of care. For example, Anthem’s initiative to address homelessness and housing instability led to a 20% cumulative reduction in medical expenses among participants, many of whom have complex health challenges, including physical and behavioral needs and substance use disorders. Even more importantly, program participants were able to maintain stable housing while improving their health outcomes.

    Priority 3: Proactively address rising behavioral health needs
    Even before COVID-19, the U.S. was facing a growing number of behavioral health issues, and the pandemic has only made things worse. An Anthem report found that 84% of healthcare professionals have seen an increase in patients requiring behavioral health services since the start of the pandemic. However, behavioral health diagnoses showed little change, and even declined for some populations, which underscored that, even as people were struggling, they weren’t receiving the care they needed.

    While we have not yet seen the full impacts of the pandemic on mental health, 92% of surveyed clinicians agree that demand for behavioral health services will only grow after the pandemic subsides. In fact, 3 out of 4 clinicians surveyed believe there will be lingering mental health impacts up to three years or longer. 

    The pandemic continues to be a humbling experience for our industry. We must use it to expand our view of health and strengthen the system to meet ever-changing demands, and prepare for the next crisis. If we do so, and continue to work together, all of us—payers, providers, governments, businesses, community-based organizations and individuals—can create a better, healthier future.

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