How Public Entity Pools Are Beginning to Address Health Inequities (October 9, 2020 Pooling Perspective)

  

By Ann Gergen, Executive Director

Given the future-minded nature of public entity pooling and heightened awareness surrounding social and economic inequalities, it’s no surprise some health pools are taking up the issue of health equity for public employee subscribers.

In conversations I’ve had over the past two months, I’ve heard of member health pools seeking to address health outcome disparities by:

  • Asking whether pool wellness incentives are respectful of income differences between the highest- and lowest-paid public employee subscribers in their membership
  • Revising pool wellness programs to recognize fundamental health needs like food safety
  • Considering whether mental health providers are diverse and reflect their subscriber populations so everyone can find a comfortable resource to meet their needs
  • Evaluating program participation and health outcomes by gender, race, age, economic status and other factors that might be influential in a person’s care and total health
  • Implementing programs that help demographically diverse populations manage health care challenges with dignity
  • Examining pharmacy benefits through a lens of inclusivity
  • Making sure claims processes (e.g., enrollment forms, benefit explanations and subscriber assistance) are provided in multiple languages and through a variety of communication channels and platforms
  • Ensuring service contracts hold third parties accountable for pool-determined health equity standards

Some of these actions are tactical and focused on routine pool operational decisions. Others are complex and perhaps outside the scope of traditional areas of pool focus. In many cases, these are challenging conversations to have because perspectives, goals and needs may vary widely among inputs and individuals (whether at the pool level or among members and subscribers). 

And, like with any other set of policy considerations, each pool will do what’s in the best interest of its members – i.e., what works for one pool may not work for another.

Pool review of health equity considerations is yet another inspiring example of this industry’s commitment to fully exploring new ideas for the benefit of members, oftentimes ahead of the rest of the industry. Pools have always innovated in response to changing circumstances – and increasing public and industry awareness of health inequities is no exception.

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Ann Gergen is AGRiP’s executive director and a former pool administrator. She has worked closely with and for pools, public entities, reinsurers and related service providers throughout her career.

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