On June 7, Amanda Pears Kelly, Executive Director of the Association of Clinicians for the Underserved (ACU), and I gave a presentation at the inaugural CMS Health Equity Conference in Washington, D.C. As strategists designing and implementing health equity advocacy programs serving individuals who are Medicaid-eligible, we wanted to focus on the power of collaboration between managed care and Federally Qualified Health Centers (FQHCs).
Our session, “Improving Equity in the Workforce by Serving the Underserved,” discussed innovative programs that help improve recruitment, retention, wellness and equity of the health care workforce. By building partnerships that continue to address inequities, we can all help shape the future of health care delivery.
Strengthening conversation and collaboration
UnitedHealthcare Community & State established an FQHC Advisory Board that serves as a council to provide input and guidance on the policy, issues and trends relevant to FQHCs. The Advisory Board’s goal is to encourage dialogue and cooperation between FQHCs and managed care.
As part of this effort, UnitedHealthcare collaborated with the ACU to support the workforce education, training, and resources ACU provides to health centers. ACU’s mission is to improve the health of underserved populations and enhance the development and support of the clinicians who serve them. In working with ACU, we have a partner that has a deep understanding of health centers, clinicians and the needs of those on the front lines of providing care.
Building and supporting a diverse workforce
Developing tools and strategies to reduce health disparities for the health care workforce is key. Through ACU’s Justice, Equity, Diversity and Inclusion (JEDI) initiative, innovative programs have been implemented that focus on cultural awareness and cultural humility. E-courses and learning collaboratives are designed to help recruit and retain health care workers. The trainings also provide tools to reduce bias and build trust between patients and providers. Multimodal communications and multiple languages enhance comprehension and effectiveness. ACU’s JEDI programs have provided vital education and training to thousands of advocates, clinicians, partners and organizations across the country.
An added consideration for FQHCs when supporting diverse, culturally responsive teams is the endemic nature of their multigenerational workforces. A recent study of 81 FQHCs from all five United States geographic regions showed that over one-half had a five-generation workforce, and one-third had a four-generation workforce.1 A staff member in their late teens may be working with a staff member in their seventies. Generational differences in health care workplaces are important because they provide enhanced creativity, improved problem solving and a better representation of FQHCs’ diverse patients. Those same differences also present equity issues with generation-specific expectations, technology proficiency, and customized learning and training needs.1
Pay equity is also intrinsically linked to JEDI. “The evolving needs of workers continue to shed light on the importance of integrating JEDI principles into the strategic and operational functions of an organization,” says the ACU. “Building a more equitable workplace means ensuring that employee compensation is fair, appropriate to the work being performed, and determined without bias.”2
Accurately identifying, collecting and acting on data
Health equity data elements are essential for identifying where disparities exist, directing efforts and resources to address these disparities and measuring progress toward improving equity and establishing accountability. Increasing the collection of standardized sociodemographic data across health systems is an important step toward improving population health.3
Current gaps in gathering effective health equity data, according to the CMS, include factors such as implicit bias, the lack of disaggregated data obscuring meaningful insights, inconsistent collection, and the omission of key social conditions elements.3
Not surprisingly, every session and discussion at the Health Equity Conference focused at some point on the need for accurate data and making sure we understand what the data is telling us. Beyond the numbers, though, one statement caught my attention: that data is also listening to community members speak their truth.
Focusing on the future
While many health centers have a solid foundation, we know that a continued focus on developing the workforce and building a shared framework for identifying and reducing health disparities and inequities is needed. It will take a whole-of-government approach for industrywide equity change, but improving workforce equity will have an enormous impact. At UnitedHealthcare, we look forward to continuing our collaboration with the ACU and others to help fulfill our joint mission to improve the health of underserved communities and enhance the development and support of the health care workforce.
- Improving workforce experiences at United States Federally Qualified Health Centers: Exploring the perceived impact of generational diversity on employee engagement (pxjournal.org)
- Equal Pay for Work of Equal Value: Establishing Pay Equity Principles to Advance Workforce Financial Wellness (Association of Clinicians for the Underserved)
- The Path Forward: Improving Data to Advance Health Equity Solutions (The Centers for Medicare & Medicaid Services)