ACHE 2015: Healthcare must focus on vulnerable populations

Healthcare's biggest challenge in an era of value-based care is to target the causes of poor health before patients require medical intervention, according to a panel discussion on population health management for diverse populations this week at the American College of Healthcare Executives' 2015 Congress.

"We definitely need to stop the bleeding and be proactive" to increase access to care for underserved populations, said panelist Jamahal Boyd, director of multicultural competence and inclusion at Mercy Health in Ohio and northern Kentucky. To effectively tackle this issue, he told attendees that healthcare leaders need to provide "a quality of care that's standard but that is delivered in a customized way." 

That goal, in turn, can't be accomplished without understanding the unique needs of diverse groups of patients, such as the aging lesbian, gay, bisexual and transgender (LGBT) population, said Jerrold Maki, vice president of special projects at Stanford Health Care (pictured right). At the very least, providers need to have "just an awareness that there's a need" to address care quality disparities among LGBT patients, Maki told FierceHealthcare in an exclusive interview.

However, the tide is definitely turning toward inclusion. "For so long, [diversity initiatives have] been focused on racial issues," he said. "Finally there's recognition that LGBTers are part of that."

Providers throughout the continuum of care also need to undergo training on how to treat LGBT patients, according to Maki. "Caregivers have to be comfortable learning about the patient's sexual history," he told FierceHealthcare.

Another group that suffers from healthcare disparities is the rising Latino population, David Luna, principal consultant for Teammates for Health Equity, said during the seminar. Access to care is a particularly pressing issue for this population, he said, so "we're going to have to figure out solutions to the fact that a large portion of the Latino population does not have a medical home."

Treating the Asian-American population, on the other hand, comes with its own unique challenges, said James Lee, executive vice president and chief operating officer at NewYork-Presbyterian/Lawrence Hospital. For example, while Asian women have the longest life expectancy of any ethnic group in the United States and Asian-Americans are less likely to live in poverty than the U.S. population, he said language and cultural barriers can impede their access to healthcare, and 50 percent of Americans with hepatitis B are of Asian descent. 

Diversity in healthcare is also an issue close to the heart of Henry Ford Health System CEO Nancy Schlichting, a member of the LGBT community who discussed the subject at a breakfast for women healthcare executives. Inclusion isn't only the right thing to do, she said, it also makes good business sense for healthcare systems. "When every community feels that this is a place where they will be treated well, guess what? We grow," Schlichting said.

While the task may seem daunting, Boyd suggested the best approach to chip away at healthcare disparities is to take on "bite-sized pieces" by developing successful outreach and health management programs. The bottom line is, "health should be available to all people the same way," he said.