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Increase Accessibility and Health Equity in Line With Predictions For the Future of Complex Care

It is no surprise that cultural and linguistic barriers have huge impacts on the quality of physical and mental health care patients receive in the United States.

This is especially true with BCNs, Beneficiaries with Complex Care Needs. These beneficiaries have cases in which their health and social conditions have contributed to an increase in costly services. In these cases, treatment must go above and beyond simply diagnosing and treating the immediate symptom and address a much deeper underlying problem.

Here are five ways Medicare Advantage providers can promote a holistic understanding of complex care cases and offset the social discrepancies that contribute to health inequality.

Steps to Holistic Complex Care

Here are four ways Medicare Advantage providers can promote a holistic understanding of complex care cases and offset the social discrepancies that contribute to health inequality.

identify more expansive risk factors

Individual treatment and health risk must be based on much broader terms than the patient’s physiological wellbeing. The ways in which patients are measuring their complete health are evolving based on personal health concerns and external guidance. Providers must consider the complexities of a patients’ care requirements, including the external and cultural risk factors that contribute to poor health outcomes.

Increased research into medically vulnerable demographics will incorporate data from health and social settings to determine the best strategies for health improvement. These studies help providers to better understand the risks different social groups face and identify opportunities for improvement. This means patient care will become more proactive instead of reactive, thereby contributing to positive health outcomes and decreasing healthcare costs to both individuals and communities. This medical proactivity in turn could help to dramatically decrease the number of complex cases.

create more comprehensive primary care

A broader set of risk factors means that primary care will become more comprehensive and complex. Primary care physicians will coordinate diagnosis and treatment with other services like behavioral health, social needs, and substance abuse disorders. This requires new ways of data sharing with other providers, promoting team-based treatment and complex care to every individual.

Clarifying what complex and comprehensive care entails also needs to become a priority. For many groups, visits to a physician occur only when an individual is sick. Limited English Proficiency (LEP) patients were far more likely than English-speaking patients to be admitted for emergency care.

Proactive, routine treatment must be communicated in the patient’s language. Furthermore, this communication should demonstrate cultural intelligence to foster strong connections and maintain trust between the patient and provider. For example, studies show a lower rate of primary care providers among Hispanic communities in the U.S. This is due to external factors, such as language barriers, low health literacy, and concerns around immigration status. By taking this into account and discussing these concerns with patients, providers can empower patients with the appropriate resources to make the best decision for their care.

become accountable for health equity

pre-pandemic, there were already significant gaps in preventative care for LEP patients for a litany of factors, including language/cultural barriers, financial restrictions, and mistrust of the medical system. Those gaps amplified during COVID-19.

While providers and healthcare studies continue to uncover how environmental differences impact healthcare outcomes, providers will also need to track financial disparities and assess how money spent ties to individual health.

This data will help identify where funding must be targeted to reduce social inequities and positively influence individual healthcare.

create diverse care pathways & address health-related social needs

Healthcare is not “one-size-fits-all,” though that is how it is implemented a majority of the time. As we mentioned, treatment is going to become more comprehensive and complex, which also means that there will need to be many more diverse pathways in treatment. This means employing treatment within healthcare and outside of healthcare, depending on the root cause of adversity.

A holistic approach which takes into account immediate medical needs and external cultural/socioeconomic dimensions gives patients an opportunity to make informed choices about their preventive care. Examples include delivering culturally relevant home and community services that reduce food insecurity, increase transportation to facilities, provide housing and support equal employment with adequate health and social benefits.

“Failing to address and resolve these social disparities, perpetuates gaps in community health. Once opportunities are identified, it is important to consider the best approach that accounts for cultural nuance.”

Medicare Advantage providers, alongside the wider healthcare community can partner with organizations who have a unique understanding of cultural complexity in care. Services such as translation and interpretation, social listening, and multicultural marketing map out the cultural landscape and identifies concerns or questions from different patient demographics.

For example, unregulated information in Spanish shared on Facebook or WhatsApp has contributed to widespread concern about the COVID-19 vaccine­–with 51% of respondents saying they believe it is unsafe.

In this instance, identifying barriers to accurate information helps providers pinpoint vulnerable populations and work to build effective communication strategies that encourage trust in preventive care.

At CQ fluency, we partner with healthcare organizations to optimize multicultural communication.

We were proud to partner with one of the country’s largest health plans to promote at-home tests for colorectal cancer. We developed culturally relevant messaging that would resonate with African Americans and Hispanics, two groups that are disproportionately affected by the disease. Contact us today to learn more about this campaign, our other work and how we can customize the right program for you.