Health Affairs, 24, no. 2 (2005): 421-423 doi: 10.1377/hlthaff.24.2.421 © 2005 by Project HOPE	New Online   Senate Health Reform Bill   Rewarding Providers   Public Option Policy Brief   Health Reform & Abortion   Delivery System Reform

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Insurers' Response

PERSPECTIVE

Verizon Works To Eliminate Disparities In Health Care For Its Diverse Workforce

Abstract

 
Eradicating disparities in health care is an ongoing process that must continue through actions from a variety of stakeholders, including employers. Verizon Communications has a diverse workforce of more than 200,000 employees and is committed to attracting and retaining a workforce that mirrors its customers, speaks their languages, and understands their needs. The company developed and implemented a comprehensive plan to help ensure that minority employees and their families receive the health care they need and deserve based on the Institute of Medicine’s 2003 report Unequal Treatment.

The company offers high-quality, affordable health care coverage to more than 800,000 employees, retirees, and family members. However, offering comprehensive health care options is only one part of a multifaceted approach to managing costs and quality. Companies like Verizon must find ways to promote and improve health as well as health care.

Verizon also has accepted the call to action from the Department of Health and Human Services to hold health plans accountable for addressing racial and ethnic disparities. The Institute of Medicine’s (IOM’s) recent report Unequal Treatment documented the impact of the unequal treatment of minorities even when access and insurance are available.¹ It listed twenty-one recommendations to eliminate racial and ethnic disparities. Employers should implement these three: (1) "increase awareness of racial and ethnic disparities in health care among the general public and key stakeholders"; (2) "implement patient education programs to increase patients’ knowledge of how to best access care and participate in treatment decisions"; and (3) "collect and report data on health care access and utilization by patients’ race, ethnicity, socioeconomic status, and where possible, primary language."²

For its own concerns, as well as those documented by experts, Verizon developed and implemented a comprehensive plan to leverage its size and influence as a major purchaser of health care services, to help ensure that minority employees and their families receive the health care they need and deserve, while maximizing its return on health care costs.

Engaging Health Plans

Top Engaging Health Plans Communicating With Employees Partnering With Employee Groups Sharing Information With Peers... NOTES

 
Verizon’s health plan management team works closely with local and national health plans, including engaging in dialogue with the plans’ senior leadership and asking about their commitment and actions to ensure high-quality health care and to eliminate disparities.

Additionally, the company surveyed more than sixty health plans and carriers to assess awareness of ethnic and racial disparities; disease management programs; communication materials; racial and ethnic data collection on membership; the racial and ethnic makeup of their provider networks; and cultural competence and sensitivity. Based on responses, Verizon categorized the plans as listed below. Categories range from "champions" in the fight to eliminate health care disparities to plans with no awareness of the IOM report.

"Best actions." These are plans that are market leaders and focus on the cultural issues of their population and how they affect health care delivery, from a culturally inclusive perspective. These plans are aware of the IOM report and other studies and have demonstrated at least one activity to address health care disparities, as recommended by the IOM.

"Least actions." These are plans that have focused only on elimination of language barriers and nondiscrimination through diversity awareness. Although these efforts assist in the translation of materials and show an appreciation or tolerance of a diverse patient base, they do not necessarily address health care disparities or cultural sensitivity or awareness directly within a clinical setting.

"No actions." These are plans that show no sensitivity to specific racial and ethnic health care disparities issues.

Continued dialogue. Gathering this information enabled the company to continue its dialogue with the plans to either support their current efforts in reducing health care disparities or encourage them to increase their activities. Health plans were notified of their category, so they could measure their current activities against the best actions. Verizon used these rankings to differentiate the market leaders and to price their offerings more favorably for Verizon’s employees.

Verizon is also participating on a panel to assess the feasibility of adding criteria for disparities reduction to health plan accreditation standards. The panel consists of representatives from employers, researchers, health plans, and health care accreditation organizations. The panel’s findings, which will be completed in summer 2005, will enable health plans and employers to target interventions to continue to fight racial and ethnic disparities in health care.

Communicating With Employees

Top Engaging Health Plans Communicating With Employees Partnering With Employee Groups Sharing Information With Peers... NOTES

 
To help educate employees, Verizon introduced the issue of health care disparities to its workforce through its regularly published employee newsletter. The article included high-level facts such as disparities statistics and possible reasons for the gap in care. It also included Verizon’s actions to reduce disparities as well as examples of how employees could work to eliminate racial and ethnic disparities. The article encouraged employees to (1) establish a regular relationship with a primary care physician (family practice, pediatrics, or internal medicine) so that the physician is familiar with the employee’s personal health history and characteristics; (2) become familiar with and take advantage of benefits within the employee’s health plan that encourage health maintenance, preventive medical care, and care management programs for acute and chronic conditions; and (3) gather as much information as possible about a previously diagnosed health condition along with any family history of health concerns and share that information with any new providers that the employee may be seeing. In addition, employees were encouraged to go to their health plans’ Web sites and other sites such as the Office of Minority Health (www.omhrc.gov) or Verizon’s internal health Web sites, which contain specific information and statistics for individual ethnic and minority groups and links to other relevant sites.

Verizon is committed to communicating with employees regularly to increase awareness and promote individual behavior change. The company is designing a comprehensive initiative targeted at improving employee awareness and actions around health improvement that will incorporate diversity in health and health care services.

Partnering With Employee Groups

Top Engaging Health Plans Communicating With Employees Partnering With Employee Groups Sharing Information With Peers... NOTES

 
At Verizon, ten employee resource groups (ERGs), including five culturally focused and one female focused, promote personal and professional growth for employees with common interests. Verizon’s health plan management team is partnering with the ERGs on getting the messages around the issue of racial and ethnic health disparities to their memberships. Chapter by chapter, the ERGs have embraced this partnership by hosting health events where they distribute health information relative to their different cultures. They also channel information to their members in meetings and through their communication networks.

Sharing Information With Peers And The Community

Top Engaging Health Plans Communicating With Employees Partnering With Employee Groups Sharing Information With Peers... NOTES

 
As part of its health care public policy strategy, Verizon has action plans to reduce racial and ethnic disparities. The company works with other employer-led groups around the country to eliminate inequitable medical treatment and to encourage research to find the best treatments for all people, given the individual differences in their medical needs and the way their bodies respond to prescribed drugs and other treatments.

In addition, through its leadership in and involvement with the National Business Group on Health (NBGH), Verizon supported the development of an innovative Employer Toolkit that includes a summary of laws and standards surrounding the collection and sharing of race/ethnicity data. The toolkit enables employers to establish immediate action steps within their organizations and through their health plan partnerships to add more power to the elimination of racial and ethnic health care disparities. One of the components of the Toolkit is Verizon’s "Disparity in Health Care Delivery Survey" sent to health plans along with the "Best Actions" benchmark responses, to help employers measure and compare their own health plans’ efforts in this area.

The NBGH, with its 225 members (52 percent of the Fortune 100), is the only nonprofit U.S. organization devoted exclusively to finding innovative and forward-thinking solutions to the most important health care and related benefits issues, including health care disparities.³

Verizon will continue to engage senior management and other thought leaders across the company to communicate the facts surrounding disparities and the losses the nation suffers by failing to tackle these problems head on. The company will include the disparities facts and action steps in its overall initiative to improve health. This strategy includes capturing demographics for future reporting and evaluation of new health plan and health management vendors.

Eradicating disparities in health care is an ongoing process that must continue through more aggressive, groundbreaking actions from a variety of stakeholders, including those with cultural competence perspectives from experts in government, academe, health plans, providers, and public and community health organizations. We cannot guarantee high quality of health care for all people until we have solved the problem of unequal treatment of minorities in the health care system.

Editor's Notes

 
Audrietta Izlar is a benefits specialist, Benefits Strategy and Design, in the Health Care Management Group, Verizon Communications, in Silver Spring, Maryland.

Verizon acknowledges Helen Darling and the staff of the National Business Group on Health, and Verizon’s Marc Reed, Donna Chiffriller, and George Crowling, for their support in addressing health care disparities.

NOTES

Top Engaging Health Plans Communicating With Employees Partnering With Employee Groups Sharing Information With Peers... NOTES

 

1. B.D. Smedley, A.Y. Stith, and A.R. Nelson, eds., Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care (Washington: National Academies Press, 2002).
2. Ibid., 20–21.
3. National Business Group on Health, "Our Mission," www.businessgrouphealth.org/about/mission.cfm (4 January 2005).

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