Achieving health equity benefits both payers and members of health care. Culturally diverse publics experience disparities in access to health care and health outcomes. Patients with poor English proficiency (LEP) experience poor health outcomes across the board, including emergency room visits and above-average hospital stays.
Most healthcare leaders agree that we need to work to improve these outcomes, but we’re not yet where we need to be. While many health systems across the country have developed promising pilot programs, there remains an urgent need to develop systematic approaches to address health disparities within diverse populations. In LEP communities, these disparities stem in part from an underlying gap in health literacy, including understanding of health insurance or access to treatment and treatment options.
Community engagement approaches can help fill this gap. Research has demonstrated both the effectiveness and cost-effectiveness of community-based programs. According to a 2020 study by researchers at the University of Pennsylvania, an initiative by community health workers produced a return on investment of $2.47 for every $1.00 Medicaid invested in the program, primarily by reducing hospitalizations among the program recipients.
For long-term success, it’s important to consider how these programs are implemented. Effective community engagement programs cannot be dictated to a community; they have to be done with the community. This means working collaboratively with community members and tailoring your content, both linguistically and culturally, to the community your team is serving, reaching them where they are and how they prefer to be reached.
Culture-tailored community engagement programs for membership and beyond
A key step in achieving health equity is to get people enrolled in a health insurance plan. In addition to providing support for urgent health issues, health insurance ensures access to preventive care, allowing members to address problems before they become serious. In many cases, health insurers can offer support for social needs such as transportation assistance or healthy food coupons. Support for these social determinants of health is often needed for diverse populations.
Choosing a health insurance plan and managing the enrollment process can be complex for many Americans, no matter what language they speak. For people with limited English proficiency, lack of familiarity with health insurance is another common obstacle. Last year, our bilingual health navigators reported that 80% of the uninsured people they enlisted had never had health insurance before. Meeting these people where they are and educating them improves membership.
Health is a personal matter and health care is complicated. Patients with LEP need good advice from someone they trust. Organizations seeking to serve LEP populations must first invest in building that trust. That’s why our team includes membership specialists and community health workers who not only speak the language but also maintain a community presence and operate from a place of cultural familiarity, creating a connection that resonates.
The importance of working within existing community structures
Building credibility takes time, but it’s easiest if you work within existing community structures. Learning which organizations serve which community and partnering with them is key. Partnerships can come in the form of referrals or co-hosting of community events, such as working with a food bank to help community members access health services and alleviate food insecurity.
Another way to build trust is to understand and use the media most favored by the communities you seek to serve. For example, organizations focused on community outreach can maintain strong ties to local media, including Spanish-language radio and TV stations. This community-based approach delivers valuable insights through trusted messengers in the community.
Don’t just introduce yourself, follow along
Enrollment awareness is only the first step. Successful community engagement campaigns provide opportunities for people to follow up, both to complete enrollment in a plan and to learn how to best use their benefits.
Hosting in-person events throughout the year where community members can come and ask questions about their coverage or bring insurance documents they don’t understand is an effective strategy. In South Florida, similar community events often take the form of Cafecitos, which are smaller gatherings that offer a chance to connect with other Spanish speakers in an informal setting to educate community members about health issues. Community outreach events that focus on specific wellness initiatives can also be effective.
Members may request the ability to follow up on information they receive at these events at a later date by taking the information they received at the event and reflecting on it further or discussing it with family or friends. Offering private, pre-scheduled virtual appointments after the event gives them the ability to ask follow-up questions and then act on their own time with greater convenience and more information from trusted resources.
Using artificial intelligence to fill knowledge gaps
These community engagement strategies have one thing in common: Planning is key. Culturally personalized interventions can be effective, but you need to know who the community is to effectively tailor these solutions. For payers, there are significant data gaps in understanding the languages spoken within a given coverage area or community.
Artificial intelligence (AI) can help fill these gaps. By cross-referencing key identifiers with a global database, AI can gather information about ethnicity and language preferences and identify 180 ethnic groups and 80 languages with over 85% accuracy. With this data, healthcare organizations can ensure all populations get the information they need to stay healthy by addressing a key cause of health inequality.
Community engagement approaches provide effective and practical solutions to achieve your organization’s health equity goals. Connection and community go hand in hand, and a healthy community is a strong community.
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