ViVE 2022: How UnitedHealth, Humana are thinking about 'techquity'

MIAMI—Two key topics have dominated the industry conversation amid the COVID-19 pandemic: health equity and the role of technology.

But these are not distinct entities, insurance executives said Monday at the inaugural ViVE Conference in Miami, and it's necessary to find the intersection, or "techquity." It's critical, they argued, that technology be viewed through an equity lens to ensure that access is fair and that the tools on offer are working for a diverse array of patients.

The national conversation about disparities, however, has helped enshrine equity as a key part of the technology conversation, said U. Michael Currie, senior vice president and chief health equity officer at Optum and UnitedHealth Group, on a panel at the conference. Currie said equity was generally viewed as "nice to have" bonus in thinking about health tech, but, over the past several years, that conversation has shifted.

"It's moved from nice to necessary," Currie said.

He said companies looking to tackle the intersection of equity and technology should consider the acronym "CPR." Addressing these challenges effectively requires C-suite buy-in, persistence and resources behind any projects.

Margaret-Mary Wilson, M.D., chief medical officer and executive vice president at UHG, offered an example of this at work during a keynote presentation. When COVID forced greater use of telehealth and technology, there were patients who were not equipped to easily adjust, lacking experience with technology as well as the devices necessary to actively engage with virtual care.

UnitedHealth, she said, identified some of its senior members who fit that bill and sent them connected devices that are designed to be easy for seniors to understand, for example with larger icons and sensitivity tuned for a senior user.

They took to those devices, she said, and the program averted at least one death.

"It's going to take all of us working together, but we absolutely are committed to our mission at United," Wilson said.

Prior to taking a role at Humana, J. Nwando Olayiwola, M.D., the insurer's chief health equity officer, was chair of the Department of Family and Community Medicine at Ohio State University (OSU). In that role, she was tasked with leading the charge as the provider adapted to COVID-19.

Once OSU stood up a new telehealth program under the pandemic, it found that about 70% of its patients who are racial and ethnic minorities said they did not feel comfortable using technology because they did not have the necessary hardware or broadband access, Olayiwola said.

"We can do a great job of bringing the technology to bear, but, if we do not make it available to people who typically cannot use it or give them the resources to be able to use it, it’s a waste," she said.

Olayiwola said areas of concern include artificial intelligence models, which may disadvantage underserved populations. Humana has signed on to an ethical AI pledge in which it agrees to review its models and take action when biases in algorithms are identified and lead to inequalities.

She added that the insurer is treating broadband access as a key social determinant, as lack of internet access can hinder patients from using most health tech options that may benefit them. In a pilot program, Humana is footing the bill for broadband for some of its members and measuring the impact that has on outcomes.

She also said it's important not to treat technology solutions as a be-all, end-all. During the pandemic, for instance, many of Humana's Medicare Advantage members reported that they struggled with loneliness. While providing them with connected devices and technology literacy help did assist in their access to care services, it didn't address the isolation at the root of their concerns.

Partnerships with companies like Papa that allowed Humana to address social needs beyond simply telehealth are also a critical piece to the puzzle, Olayiwola said.

"This is a moment that everyone is kind of hip to health equity and tech equity, and we’re trying to figure out how this tide will change and if it will at all," she said.