Atrium Health - Atrium Health is a nationally recognized leader in shaping health outcomes through innovative research, education, and compassionate patient care. Based in Charlotte, North Carolina, Atrium Health is part of Advocate Health, the third-largest nonprofit health system in the United States. Their intervention addressed disparities in colorectal cancer screening rates that impacted racial and ethnic minorities. They achieved this by improving their data collection efforts and by collaborating more effectively with community partners. Atrium Health reduced disparities through a redesign of their electronic medical records (EMR) that transformed the way they collect demographic data.

They added or improved questions regarding race, ethnicity, language preference, sexual orientation, assigned sex at birth, and gender identity – and created a data tool that has mortality, diabetes, hypertension, colorectal cancer screening, and high-risk medications stratified by race, ethnicity, gender, and location. Leveraging this data, they implemented culturally appropriate interventions at the primary care practice and community levels. These interventions included a phone outreach campaign and collaboration with a Spanish-language newspaper, which resulted in 200 additional screenings, and the early detection of certain cancers.

UnitedHealthcare - United Healthcare is an operating division of UnitedHealth Group, a leading health carrier in the United States. They implemented numerous activities to reduce disparities in maternal health. They identified gaps in postpartum care among Medicaid enrollees and designed culturally and regionally appropriate interventions across three states to address these disparities.

Their primary focus was to promote early and comprehensive postpartum care by utilizing community health workers (CHWs) to evaluate, assist, and support members’ unique needs in Michigan, Ohio, and Hawaii. These efforts included home visits, collaboration with local primary care and obstetric nurse partnerships, and care coordination.

HealthPartners - HealthPartners is a consumer-governed health care organization covering 1.8 million members nationwide and serving 1.2 million patients across six states through more than 90 medical, dental, and hospital locations in Minnesota and western Wisconsin. Their strategic focus on health equity spread organization-wide and includes collecting data to eliminate disparities in care, supporting language access, partnering with communities, and building an organizational understanding of equity, diversity, inclusion, and bias.

HealthPartners’ organization-wide approach helped them reduce health disparities in the clinic, health plan, and hospital settings. Through the implementation of numerous culturally tailored initiatives for racial and ethnic minorities and individuals with limited English proficiency, HealthPartners was able to successfully close the colorectal screening gap between white and racial and ethnic minority patients by one-third, from 11.5% to 7.6% in one year; shrink the disparity in anti-depression medication compliance between whites and racial and ethnic minorities by one-third, from 18.7% to 12.8% over three years; and nearly eliminate the gap in mental health length of stay between patients with limited English proficiency and those who prefer to communicate in English in one year.

Centene Corporation - Centene Corporation, a Fortune 100 Company, is a diversified, multi-national healthcare enterprise that provides a portfolio of services to government sponsored and commercial programs, focusing on under-insured and uninsured individuals. Informed in part by the CMS issue brief, Increasing the Physical Accessibility of Healthcare Facilities, Centene recognized the need to address the significant barriers to access that individuals with physical accessibility challenges face when trying to get needed health care.

As part of its ongoing commitment to provide equal access to quality healthcare and services, Centene announced in 2018 that it would partner with the National Council on Independent Living (NCIL) on an initiative to increase the accessibility of provider medical offices and services for people with disabilities. The Provider Accessibility Initiative (PAI) kicked off with the “Barrier Removal Fund” (BRF) in three pilot states, Illinois, Texas, and Ohio. The goal of the initiative is to provide equal access to quality health care and services that are physically and programmatically accessible for its members with disabilities and their companions by increasing the percentage of Centene providers that meet minimum and federal state disability access standards. To date, 52 health care providers in Illinois, Texas, and Ohio received grants from the Centene Barrier Removal Fund. The grantees range in size, location, and specialty and include both physical and programmatic access improvements. In addition, over 2,500 onsite Accessibility Site Reviews have been conducted across California, Illinois, Texas and Ohio. As a result of these efforts, over 36,000 of Centene’s members now have improved access to their provider’s office. In 2019, Centene plans to roll out this initiative in Florida, Kansas, and New Mexico, and continue its efforts to develop data collection processes and directory improvements that can be scaled across states.

Kaiser Permanente - As one of the nation’s first health care providers to racially integrate its hospitals and waiting rooms, as well as hire a diverse workforce, Kaiser Permanente has seven decades of experience promoting diversity, inclusion, and health equity. This longstanding commitment to equitable care has enabled Kaiser Permanente to become an industry leader in developing and implementing best practices, approaches and evidence-based medicine aimed at improving health equity outcomes. As one instance of these targeted improvements, Kaiser Permanente’s Hypertension Program Improvement Process has bolstered blood pressure control rates among its members across racial/ethnic groups, showing significant and sustained improvement in hypertension control levels for Kaiser Permanente’s African American Medicare members, ages 18 to 85.

From 2009 to 2017, the percentage of African American Medicare members with controlled hypertension increased from 75.3 percent to 89.6 percent. During this time, as a result of Kaiser Permanente’s focused and sustained efforts, the African-American–White disparity in hypertension control rates was reduced from a high of 5.3 percentage points to 2.2 points (a 58 percent decrease). Throughout this period, hypertension control rates for all racial and ethnic groups have consistently surpassed the HEDIS national 90th percentile for Medicare members. Kaiser Permanente has ensured that all members receive the highest standards of care while closing the gap in outcomes between two populations they serve.

Novant Health - Novant Health’s mission is to improve the health of communities, one person at a time. To support this mission, their President and CEO signed the #123forEquity Pledge to Act to eliminate healthcare disparities in April 2016 and a multi-disciplinary team was identified to focus on health equity. This team discovered a disparity in pneumonia readmission rates. The Novant Health team performed 100 comprehensive medical record reviews, looking at 29 clinical and socioeconomic data elements in order to understand the root causes of this disparity. As a result, Novant Health identified opportunities related to the discharge process, patient support after discharge, comorbidities and mortality rate. The team formed five work streams to develop targeted interventions: discharge, population health, home visits, access to healthcare and creating awareness.

Within one year, between January-September 2017, Novant Health successfully closed the gap: the disparity for African American patients who were readmitted with a diagnosis of pneumonia was reduced by 50% (from 4% to 2%) in comparison to the other populations served. This project has created a framework and blue print that is being utilized for other health equity initiatives both within the system and in the communities that Novant Health serves.