Hospital leaders must ensure it’s a goal throughout the entire organization, and there must be accountability, he tells Chief Healthcare Executive.
Nashville - Hospital executives that are looking to improve health equity must make it a goal throughout the entire organization, Jay Bhatt says.
Bhatt is a managing director of Deloitte and directs Deloitte’s Health Equity Institute. At the ViVE Conference, he spoke about what hospitals and health systems must do if they want to close disparities in underserved communities.
He sees these issues up close. Bhatt is a practicing physician who spends several days a month caring for patients in a community health center in Chicago. Most of the center’s patients are people of color and rely on Medicaid.
Bhatt spoke with Chief Healthcare Executive® about health equity, how leaders can drive change, and the importance of building trust in the community to make a difference.
“Health equity can’t be a side hustle,” Bhatt said.
“It's got to be part of the business, embedded within your thinking, your strategy, your finance your operations.”
(See part of our conversation with Jay Bhatt in this video. The story continues below.)
Deloitte has been increasingly focused on the issue of health equity. In July 2022, Deloitte’s actuaries concluded that inequities across the healthcare system cost Americans $320 billion annually. Unless progress is made, the costs could grow to $1 trillion annually by 2040.
On an individual level, health disparities already cost each American $1,000 annually, Deloitte concluded. By 2040, that could rise to $3,000 annually if current trends continue.
“Everyone’s paying for health equity, whether it’s premiums, increases, uncompensated care, taxes,” Bhatt says. “We’re in crisis and health equity is everyone’s business.’
To move the needle on health equity, hospitals need to set clear objectives with tangible goals.
“I think you've got to have a credible, measurable strategy,” he explains. “You've got to have accountability across the board, not just with the C-suite, but with governance, with your middle management, and with employees across the organization.”
Without a well-articulated strategy, Bhatt says, “You’re not going to have success.”
Bhatt sees a great deal of variation in health equity efforts.
“There’s still challenges around organizations seeing how it engages with the business case,” Bhatt says.
“Health equity, for most organizations, they’ve got to figure out where to start, how to have early momentum, and then continue it,” he says. “But it’s got to be embedded in the DNA of the organization.”
Hospitals should view health equity as a way to stand out among rivals.
“Health equity can change the basis of competition for organizations, if they think about it in a holistic way, in terms of patient and consumer loyalty,” he says.
Health systems can use digital tools, including telehealth and remote patient monitoring, to improve patient outcomes in underserved populations, Bhatt says.
“Virtual and digital has tremendous opportunity to advance health equity,” Bhatt says. It's, again, one component in a continuum of care delivery that leads us to equitable health outcomes.”
In an encouraging sign, most Black and Hispanic Americans are willing to use virtual and digital care for preventive visits and mental health issues, Bhatt says. If health systems have the opportunity to develop longer relationships with patients from these underserved communities, they can pull data from these visits and gain insights that can improve care.
“It's a more of a series, like a Ted Lasso series, and not just one episode,” Bhatt says. “You're seeing a holistic view of those digital biomarkers that then help you make decisions.”
Hospitals and health systems may need to work with partners to generate data to reveal which populations are seeing worse outcomes.
But health systems don’t necessarily need to start from scratch.
“I think we have data that we need to make progress,” Bhatt says. Health systems may see a gender gap in readmissions with a condition such as diabetes, he says.
In fact, health systems can gain some insights by looking inside their own organizations.
“There's different ways that you can look at your data even within your own employees,” Bhatt says.
Engaging the community
Healthcare organizations that have been successful in improving equity have spent a great deal of time talking to members of the community and listening to them.
Hospitals and health systems that are seeing progress are “spending time in the community in an authentic way,” Bhatt says.
Some in underserved communities may not have the highest regard for their health systems, especially if those individuals haven’t been treated well in the past.
Hospitals can build trust by owning up to mistakes, Bhatt says.
“Have courageous, tough conversations to learn where you are as a health system,” Bhatt says. “This is what we don’t know. This is what we do know. This is where we’ve gone wrong.”
And he adds, “It’s how you show up consistently, and work with the community, as opposed to telling them what to do.”
In terms of tackling community issues, health systems need to work with community members, and other organizations, to craft a solution to a problem.
It’s critical for hospitals and health systems to follow their words with actions. If systems raise expectations, then they have to meet them.
“There’s a lot of times we say we’re going to do something to help patients, consumers with an issue, but then we don’t,” he says.
“When we don’t deliver, we lose trust like that.”
Even with much progress to be made, Bhatt remains optimistic about the prospect of improving patient care for all groups.
“For the first time that I can remember in my lifetime, I can see greater alignment of stakeholders around health equity than I’ve ever seen before,” he said.