Humana, Optum Health Execs Describe Building Health Equity Infrastructure
During last week’s Primary Care Transformation Summit, Amy Nguyen-Howell, M.D., M.B.A., chief of the Office for Provider Advancement at Optum Health, and Nwando Olayiwola, M.D., M.P.H., chief health equity officer and senior vice president at Humana, detailed the data infrastructure they are building in their respective organizations to support health equity initiatives.
As Humana’s first chief health equity officer, Olayiwola said her job is to make sure that they find a way to integrate health equity concepts into all the work that they do on the payer and provider sides. She noted that the company’s CenterWell provider organization has over 250 primary care clinics across the nation, as well as home care and pharmacy services. “We're now the largest provider of senior-focused primary care in the nation, so we are very much thinking about how we make sure that primary care has all the tools that it needs to be able to achieve health equity.”
She described organizing their health equity strategy is around three strategic priorities. The first one is around improving understanding disparities and making improvements related to access to care. The second one is understanding disparities related to quality of care and working to improve that quality, and the final one is addressing non-medical barriers to care, such as environmental challenges, education, and literacy.
“One of the first things that we did was start to disaggregate our data to really understand what do we know about our members and our patients," Olayiwola said. "Given that we're both insurance and care delivery, what do we know about about them in all the different domains that we look at our patients and members — clinical outcomes, health-related social needs, financial, all sorts of things, and really understanding what challenges we had and then started to build a strategy around working to address those areas, and we landed on access, quality and non-medical barriers as our three strategic priorities.”
Nguyen-Howell began by noting the scope of Optum Health’s reach. “Within Optum Health itself we serve about 101 million consumers, with over 3 million patients under fully accountable value-based care arrangements. We have over 70,000 aligned physicians, which includes about 7,700 employed physicians. We have over 2,000 sites of care. We have about 100 payers across the country and over 29,000 advanced practice clinicians. We are serving one out of three Americans this year,” she said.
She described efforts at Optum Health to build a disparities analytics dashboard.
They are working to capture self-reported REL-SOGI data — race, ethnicity, language, sexual orientation, and gender identity data. “That means whether it's screening capabilities or building the data infrastructure, we're really going to embrace and capture that self-reported data,” Nguyen-Howell said. “The second initiative, as we build the data infrastructure, is to have a bi-directional data exchange of REL-SOGI data. That involves basically developing a data architecture and infrastructure across our businesses, across our markets, to make this self-reported data available, because, as we know, we can't improve what we can't measure. We can't measure it without reliable valid, viable data.”
Optum Health is also working to establish an SDOH data registry. “We hope to capture and store the SDOH-related data in an organized way so that we understand their needs in real time,” Nguyen-Howell said. “It can inform referrals, it can inform closing care gaps in real time and obviously inform improving quality of care, as we try to close the healthcare gaps and improve outcome measures for our members and our patients”
Optum Health also has focused on rolling out health equity training across the organization, she added.
Olayiwola said they did an early sprint when she first got to Humana around data disaggregation. “We built out a really sophisticated internal use-only population health analytics business intelligence tool, which allows us, at any level of the organization, within any market, to drill down to understand what are the social needs of the members and the patient that we have in that area,” she said.
“What sorts of disparities do we have in some of the outcomes?” Olayiwola said. “We look at chronic diseases — cardiovascular disease and hypertension and diabetes. It allows you to understand where you have places where we really do need to focus our energy and efforts, design and co-design programs and initiatives to help address those things,” she explained. “That sophistication around data intelligence and pop health business intelligence provides a resource to teams across the country. It’s been enormously helpful. We've got a very strong community engagement community partnership team. And as I mentioned, we're focused on social needs in a very meaningful way, but also it allows us to widen the aperture around health inequities, because we know that social needs are one part of that work, but we know that our providers need tools and resources to help them address challenges that they find.”
