5
Adopt a bundled payment model for home-based and outpatient palliative care.
Ensure palliative care reaches and meets the needs of communities of color and other historically marginalized populations. This includes considerations based on race/ethnicity, language, gender identity, sexual orientation, age, income, geographic location, diseases, disabilities, and social needs such as housing status.
Considerable inequities in health and health care persist for diverse populations, including those with serious illnesses. A 2019 statewide survey in California revealed disparities among people of color and low-income individuals regarding the absence of crucial conversations about medical preferences, experiences of discrimination when seeking healthcare, and levels of trust in healthcare providers.
The field of palliative care is still in the early stages of learning how to ensure it reaches and meets the needs of communities of color and other under-served populations. Even as new knowledge is being developed, health plans can take steps to identify and address inequities, such as analyzing data to identify areas of disparity, listening to community needs, and tailoring programs to meet those requirements. Additionally, health plans can hire or contract with more clinicians who reflect the diversity of the community being supported.
Reference: Help Wanted: Californians’ Views and Experiences of Serious Illness and End-of-Life Care. California Health Care Foundation, October 2019
EQUITY
THE ESSENTIALS
At the very least, start here
PROGRESSING FURTHER
Take the next steps
SETTING THE STANDARD
Strive for excellence
Action Items
At the very least, start here
Prioritize contracting with providers and hiring plan staff who have characteristics in common with your members.
Regularly evaluate enrollment and service outcomes to identify disparities associated with member characteristics, including race/ethnicity, language, gender identity, sexual orientation, age, income, geographic location, diseases, disabilities, and social needs, such as housing status
Initiate or expand internal diversity, equity, and inclusion (DEI) activities to address how internal and external work cultures and practices contribute to inequities, and explore ways to bring about positive change.
Blog
How Medicare Advantage Could Address Pain Inequities For Black Patients Living With Serious Illness (Health Affairs)
Health Affairs blog with actionable steps for Medicare Advantage plans to address disparities in pain management for Black members.
Toolkit
Health Equity in Palliative Care Toolkit (Center to Advance Palliative Care)
Curated tools and resources to improve the quality of serious illness care provided to historically marginalized and under-served patient groups.
Report
Equitable Access to Quality Palliative Care for Black Patients: A National Scan of Challenges and Opportunities (Center to Advance Palliative Care)
Report summarizing challenges, opportunities, and possible interventions to improve equity.
Report
Improving Access to and Equity of Care for People with Serious Illness (The National Academies Science, Engineering, and Medicine)
Summary of workshop proceedings providers can use to deepen understanding of challenges, opportunities, and possible interventions to improve equity.