Cain Hayes is steadfast in Point32Health’s commitment to creating meaningful change in addressing health inequities and building a healthcare system where no one is left behind. Point32Health has prioritized health equity, and colleagues at every level of the organization are focused on ensuring that addressing social determinants of health is at the heart of everything they do. Point32Health is continuously developing and implementing innovative programs and initiatives that address health inequities head-on.
In the past few years, health equity has finally received the attention it deserves. How would you define it and how is Point32Health addressing inequities?
Cain Hayes: Health equity is when everyone has a fair and just opportunity to attain their highest level of health. Ensuring people can live longer, healthier lives is dependent on making care more readily accessible and closing gaps in care for vulnerable populations. In 2022, we launched the Point32Health Corporate Health Equity Program to unite the health equity work across the organization, resulting in broader impact and outcomes. This approach positions Point32Health and our health plans, Harvard Pilgrim Health Care and Tufts Health Plan, to best address disparities and to improve health equity in our member population and the communities we serve. Our health equity efforts are focused on collaborative strategies that maximize internal efforts and leverage public and private collaborations.
What programs and initiatives has Point32Health implemented to address health inequities?
CH: We work closely with providers on contractual agreements that target the reduction of health disparities. Our Quality Advance Program (QAP), which is built into our provider contracts, includes provider-specific compensation and incentive strategies that are designed to support the direct care component of disparity reduction as well as tracking and analyzing data to show if programs are impactful. One of the many focus areas that we feel we can have a significant impact on is maternal health. Point32Health has implemented quality measures and different payment models to incentivize better care and outcomes for women of color. Additionally, we created doula programs for women experiencing high-risk pregnancies, and recently partnered with providers and a community-based organization to assist at-risk pregnant women experiencing food insecurity with nutritionally appropriate home-delivered meals. Further, we collaborated with regional providers to introduce the TeamBirth initiative, which looks to improve both safety and dignity in childbirth, as well as reduce cesarean sections.
How have the challenges over the past few years, specifically the COVID-19 pandemic, influenced the health community in how it can address health inequities as an industry?
CH: If there is anything I have learned over the last several years, it’s that we all must work together as a community to combat the challenges we face, and collaboration is key to developing meaningful solutions to any challenge. The pandemic shined a light on the inequities in our communities, but these inequities were not new. For those of us in healthcare, we must make addressing these inequities a strategic priority and make it a part of every process and every decision. Building a more equitable healthcare landscape is a collaborative effort involving industrywide healthcare organizations; local, state, and federal agencies; and so many others. We must all address the social determinants of health head-on, including discrimination. We also must invest resources in creating and delivering culturally competent health services—this will help improve health outcomes and can help eliminate ethnic and racial health disparities.
What's one of the biggest challenges payers face in addressing health equity?
CH: One challenge that payers face is tracking comprehensive data related to health inequities—but it’s getting better. For several years, gaps existed in access, cost and quality for patients based on race, ethnicity, gender, age, sexual orientation and other demographic and socio-economic factors. These gaps often meant inequities remained unaddressed. At Point32Health, we remain laser-focused on continuing to work diligently in providing up-to-date and in-depth data to our provider community. This data is crucial to advancing health equity by identifying health disparities, developing interventions to address them, and measuring the efficacy of health equity initiatives.
