Redefining Health Equity: Insights from the San Diego Healthcare Leaders Conference and Beyond

The ABIG team just came back from the San Diego Organization of Healthcare Leaders conference where Dr. Adam Brown discussed a layered approach health equity that includes:

• As citizens, calling for a change in the structure of healthcare financing and advocating for public policy that does not pick winners and losers.  

• As business leaders, focusing less on profit and more on whether a new program will expand healthcare access. 

• As players in a vast ecosystem, understanding the needs and pressures of all stakeholders, how they communicate, and where they get their information.

These themes were prominent in the news over the last two weeks as well. Let’s dive in. 

When it comes to AI, health execs have some blind spots

That is the conclusion of a new study by Deloitte featured in this HealthcareDive story. 

For example, executives are not nearly concerned about how consumers, or even their own employees, feel about the march toward using artificial intelligence in healthcare. Indeed, “Just half of respondents rated building trust among consumers regarding data sharing at the top of a five-point scale when asked about their greatest considerations for establishing generative AI.” Additionally, while 82% of execs rated data availability, quality, and reliability as a top consideration when it comes to AI, only 45% said mitigating biases is a significant consideration. 

It is in executives’ best financial interest to eliminate these blind spots. Why? As Lainie Dorneker, head of healthcare at Bowhead Specialty Underwriters Inc., explained at the Business Insurance World Captive Forum, leveraging AI without considering its quality and reliability increases insurance risk and liability exposure. 

Our BIG Thoughts: AI holds so much promise for healthcare. As Fierce Healthcare noted, it even could open the “black box” that is mental healthcare. But trust is the foundation of the doctor-patient relationship. If execs do not address consumer concerns, those worries could keep patients from coming to the doctors’ office at all. 

Healthcare workforce issues spell trouble for improving health equity

As Becker’s Healthcare noted last week, for nearly two decades before the COVID pandemic hit, the top headache for hospital CEOs, according to American College of Healthcare Executives' annual survey, was financial challenges. 

Since 2021, labor has been the top pain point. 

And now, according to a new study published in JAMA Health Forum, we know this concern could also spell trouble for the country’s efforts to address health equity. As AXIOS noted, a disproportionate number of women and Black workers are exiting healthcare. Furthermore:

• Employers are having harder time recruiting Black workers after the pandemic; 

• Even though overall employment levels appeared to stabilize by the end of 2020, the exit rate rose, starting in the Northeast and gradually spreading to more states in the South and West; and

• While the increase in healthcare hiring masked some of the churn, providers were left operating with less-experienced staff.

Our BIG Questions: What about the industry makes it an increasingly hostile one for women and people of color? (Could it be that they face discrimination from the moment they enter training programs or medical school?) What are the solutions? How do we go beyond DEI task forces to something deeper?    

The other side of that No Surprises Act story…

On Jan. 29, HealthcareDive reported that, according to America’s Health Insurance Plans (AHIP) and the Blue Cross Blue Shield Association, the No Surprises Act (NSA) “prevented more than 10 million unexpected bills in the first nine months of 2023.”

Let us be clear: The healthcare billing system has, for generations, been opaque. Transparency is very much needed. But there is another side to this story, and one that could have serious consequences for doctors, nurses, and, most importantly, patients. 

According to the Government Accountability Office, the rollout of the NSA independent dispute resolution process has been “challenging.” As of June 2023, more than 490,000 disputes had been submitted, a much larger number than anticipated. Nearly two-thirds were still unresolved as of June 2023.

That means providers are not getting paid, and there are consequences to that outcome. Last fall, for example, MedPage Today reported that because of the NSA emergency department wait times have doubled since 2020 and implementation of the rules has “inflamed an existing staff shortage.” 

Our BIG Thought: Staff shortages and ER wait times are not the only problem. If federal lawmakers do not address the NSA’s very real unintended consequences, the country is in for more hospital and provider group bankruptcies. More providers also will flee the market. 

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