5 questions on health equity

Addressing inequities in health care among populations is a core focus of Optum Rx. We recently sat down with Corey Coleman, Vice President of Health Equity Business Enablement for UnitedHealth Group to learn more about the steps Optum Rx is taking to help identify and remove the obstacles impeding better access to health care for all.

1. The topic of Health Equity is broad. Can you help narrow down what we mean by Health Equity and speak to why address addressing it is so important?

Corey Coleman: Thanks for the question. Number one, Health Equity means helping people live their healthiest lives by ensuring they receive the care and support they need to achieve optimum health. So, this means eliminating inequities in how people access and receive healthcare.

And what I think is important to understand is we have a long way to go in terms of getting everyone access to care in a way that they actually can have a positive impact and positive outcome on their health. That’s why our work is really focused on understanding where those gaps are in our systems.

• Where are the populations that are seeing challenges in a disproportionate way?
• What are the things we can do both internally and externally to improve care and health for those populations?

2. Given the scope of the challenge, where do you start? Is there a high-level strategy to begin with to start addressing health inequities?

CC: Absolutely. I think it's really important to be clear and succinct around the Health Equity strategy we have at Optum Rx.  For one, we have great leadership that absolutely believes in this work. They understand the importance of providing resources to both improve existing internal systems and also provide the funding that enables us to innovate and create new solutions for populations.

So, what we've done in our organization is really orient ourselves around three priorities. As I alluded to, our first priority involves improving our processes and redesigning data systems to better identify and address health disparities in the populations we serve.

A second priority is to create focused strategies for chronic conditions and diseases. A good example of this is diabetes and hypertension, where we know that we have significant populations that are facing disparities related to that chronic condition. So, there’s a great opportunity for Optum Rx to focus in on disease-specific challenges confronting certain populations and create solutions tailored to those needs.

Our third priority is our commitment to community empowerment and engagement. There is a deep understanding that we are members of our community and thought leaders in the health care space.  It's really important as an organization to partner where it's appropriate to provide both resources and insights to help the patients that we are ultimately supporting in their respective communities.

3. Any current initiatives underway that are showing promise you'd like to highlight?

CC:  We have a number of different programs underway that I would highlight.

One place we can start is our Optum Savings IQ™ program. I think it's a really great example of understanding a problem, designing a solution, and then rolling that out to improve care. Optum Savings IQ is funded through the Health Equity budget and helps Optum Specialty Pharmacy patients. The program identifies financial insecurity for certain patients who are eligible to receive infusion medication or other specialty medications, which tend to be very expensive for patients.

Optum Savings IQ is a cutting-edge technology that automatically aggregates opportunities to match eligible Optum Specialty patients with financial assistance. This can be co-pay cards, grants, foundations, manufacturer credit cards or free drug programs that help reduce out-of-pocket costs and improve medication adherence. Since Optum launched this technology, the average out-of-pocket cost for oral oncology patients has decreased by 88% and on average, Optum Specialty Pharmacy patients have only a $5 copay.¹ Coupled with other financial assistance resources, Optum is on pace to deliver $1 billion in total patient savings in 2024.² Ultimately, we have tools to help these patients find ways to defray costs.

And so that's a really good example of identifying a problem and understanding what those barriers are. In this case, the barrier was financial insecurity. We brought that insight back to our organization, developed a solution, worked with other teams throughout the organization, and rolled this out as a new program. Again, this type of innovative solution cannot happen without the diverse set of business leaders from Optum Rx that are helping to enable and actually execute this work.

4. You touched on the financial insecurities many patients face. Can you talk about the social determinants of health and how we can help address challenges that are outside of the pharmacy benefit?

CC: Sure. Our network team in particular has done some really great work partnering with independent pharmacies. Last year, we launched a unique program in partnership with independent pharmacies that enabled us to implement SDoH screenings, along with referral resources for patients. We have resources through organizations like Unite Us to point them to solutions that are right in their neighborhood. These screenings were offered either at the pharmacy counter or through outbound telephonic outreach, enhancing accessibility and patient engagement

This is just one of many community and strategic partnerships we have forged to help advance Health Equity. For example, we've done partnership work with the American Diabetes Association to provide diabetes education materials and nutritious food in a simple, approachable way to community members living in Philadelphia.

Additionally, we recognize the importance of representation of minorities in the pharmacy profession is low, and therefore we created a scholarship program with Florida Agricultural and Mechanical University to fund graduate pharmacy students.  In all, 20 students are receiving aid as a result of our commitment to the next generation of pharmacists.

5. Let's look forward. How do you keep this momentum going over the longer term?

CC: There has to be a continuing education of stakeholders around why this work matters, why it's important. Health Equity is not a side project, it is not a special project — it is core to the business of what we do.

I would challenge health care leaders throughout the country to think about this fact. I don't think any of us should be able to look into any of our systems and see differences among groups, regardless of what the chronic condition happens to be. That's the starting point. Until we cannot tell the difference between Patient A versus Patient B, who are the same age, same chronic condition, same life expectancy, we all have a long way to go in terms of making sure we don't have health inequities in our system.

There’s also the constant evolution of the regulatory and compliance environment. So not only is Health Equity important for businesses to do from a Health Equity standpoint, but we are also starting to see more and more government regulations and requirements. That trend is not going to stop, so the better we can position our systems to identify disparities and help address them, the better off we will all be.

Since we are looking ahead, I do think it's important to recognize the potential of artificial intelligence as it pertains to Health Equity. That said, I think there has to be extreme caution around using it. There is potential for us to see some really powerful innovations using AI tools to identify health inequities, but we must only do so in a very careful, deliberate and respectful way.

In in the end, no matter which solutions we are employing, we need to remain focused on the goal of continuing to improve health outcomes for all patients disproportionately impacted by chronic conditions while continuing to reduce healthcare costs and developing system improvements and better products and programs.