Health care system

Organizations aim to connect patients, therapists of color

A number of new organizations aim to digitally connect patients with mental health providers who value and understand different cultures (Source: “It’s Hard to Search for a Therapist of Color. These Websites Want to Change That.,” New York Times, July 16).

In recent years there has been an expanding number of digital companies and nonprofits created to help people of color find a therapist they can trust — someone who is not only skilled in the best evidence-based treatments but also culturally competent. In other words, a provider who is aware of their own world views, knowledgeable about diversity and trained to connect with different types of clients.

The founders of these organizations say there has always been a need for such services, and even more so now that people are coping with the stressors of the pandemic and the racial reckoning that followed the killing of George Floyd by the Minneapolis police.

Studies have shown that mental health treatments can be more effective when a client feels that their therapist values culture.

It can be difficult for people of color to locate a therapist with a shared cultural background.  An American Psychological Association report found that only 5% of psychologists are Hispanic and 4% are Black — 86% are white. A similar disparity exists among the country’s social workers and psychiatrists.


Low number of Black dermatologists could hurt quality of care, providers warn

For people of color, basic dermatological conditions sometimes go undiagnosed or misdiagnosed by doctors unfamiliar with treating darker skin, healthcare professionals say (Source: “Skin color matters: In dermatology, patients' diversity calls more Black doctors,” Columbus Dispatch, July 29).

According to a June 2017 study published in the Dermatology Journal of the American Medical Association, 3% of dermatologists in the United States were Black. In 2020, 13.4% of the U.S. population was Black or African American, according to the U.S. Census.

A lack of diversity in any medical field can hurt the quality of care given. And a doctor from one ethnic or racial background might be able to offer information not necessarily taught in school.


States reluctant to target hospital costs in employee health plans, new study finds

Hospital prices are cited most frequently by state plans as their top cost driver, but state negotiators are more likely to target other forms of health care spending when it comes to curbing costs, a new study found  (Source: “States don't want to tackle high hospital costs,” Axios, June 17)

According to a new study by Georgetown's Center on Health Insurance Reforms, state health plan administrators are “fully aware that hospital prices are the primary driver of the steady increase in the cost of employee health benefits. Yet they remain focused on secondary drivers such as excessive or inappropriate utilization.”

State employee health plans are often the largest employer purchasing insurance in their state, so in theory, should have significant clout when negotiating prices. But according to the report, plan administrators say it is hard to go after these prices because of a lack of competition between hospitals, hospitals' political clout and employee pressure to keep broad provider networks.


New tool tracks health disparities in U.S.

A coalition of researchers and advocates launched a tool this week they hope will fill some of the gaps in data on racial disparities in the U.S. health system (Source: “A new tool tracks health disparities in the U.S. — and highlights major data gaps,” Stat News, May 26).

The Health Equity Tracker is a portal that collects, analyzes and makes visible data on some of the inequities entrenched in U.S. medicine.

“For far too long it’s been ‘no data, no problem,’” said Nelson Dunlap, chief of staff at the Satcher Health Leadership Institute at Morehouse School of Medicine, which developed the tool with funding and resources from Google.org, Gilead Sciences, Annie E. Casey Foundation and CDC Foundation.

By making data accessible that highlights racial health disparities, the tracker aims to empower local advocates to drive change in their communities — and inspire action to fill in holes in data that are themselves reinforced by structural racism. In the tracker’s display, 38% of federally-collected COVID-19 cases report unknown race and ethnicity.


AMA announces plan to combat racism in U.S. health system

The nation’s largest doctors group earlier this month released a  plan aimed at dismantling structural racism inside its own ranks and within the U.S. medical establishment (Source: “US doctors group issues anti-racism plan for itself, field,” Associated Press, May 11).

The American Medical Association’s plan has been in the works for more than a year. The group’s leaders said health inequities highlighted by the pandemic, ongoing police brutality and recent race-based crimes have given the effort a sense of urgency.

The AMA plan calls for more than diversifying its staff and adding members who are from Black, Hispanic, Indigenous and LGBTQ communities. It aims to embed anti-racist activities and education at every level of the organization. The influential advocacy group also plans to use its clout to advocate for health equity public policies and to create and deliver anti-racist training for medical students, doctors and health systems.


Most and least racially inclusive hospitals often in same city, new analysis finds

A new ranking of U.S. hospitals’ racial inclusivity suggests that many of the country’s most segregated hospitals are in urban areas and that top and bottom performers are frequently located within the same city (Source: “In many U.S. cities, most and least racially inclusive hospitals are neighbors, Lown Institute says,” Fierce Healthcare, May 25).

Further, the Lown Institute analysis placed more than twice as many “elite hospitals” named to U.S. News’ Honor Roll in the bottom third of the racial inclusivity ranking than it did in the upper third.

“The difference between the most and least inclusive hospitals is stark, especially when they are blocks away from each other,” Vikas Saini, M.D., president of the Lown Institute. “As the nation reckons with racial injustice, we cannot overlook our health system. Hospital leaders have a responsibility to better serve people of color and create a more equitable future.”

Announced today by the Lown Institute, the list ranks more than 3,200 hospitals using Medicare claims and U.S. Census Bureau data from 2018. The group awarded higher scores if the hospital served a greater proportion of non-white Medicare patients compared to the demographics of its surrounding community.

Both Cincinnati and Cleveland made the Institute’s list of the 25 U.S. cities with the most segregated systems.


Medical school enrollment among Black men, Native Americans declines

A comprehensive new analysis of 40 years of medical school admissions data found the number of Black men and Native American and Alaskan Native men and women has declined (Source: “After 40 years, medical schools are admitting fewer Black male or Native American students,” Stat News, April 28).

The two are the two most underrepresented in U.S. medical schools, and their numbers are getting worse, according to a study that was published this week in the New England Journal of Medicine. While Black male medical students accounted for 3.1% of the national medical student body in 1978, in 2019 they accounted for just 2.9%. Without the contribution of historically Black medical schools, just 2.4% would be Black men. The number of Native American students, both male and female, also declined, accounting for just a fraction of 1% of the nation’s roughly 22,000 medical students in 2019.

“It is absolutely dismal and appalling and quite frankly unacceptable,” said Demicha Rankin, an anesthesiologist who serves as associate dean of admissions for The Ohio State University Wexler Medical Center, where 25% of students come from underrepresented minority groups.


Ohio ranks near bottom in latest HPIO Health Value Dashboard

Ohio ranks 47 in the nation in health value compared to other states and D.C. according to the latest edition of the Health Value Dashboard, which was released earlier this week by the Health Policy Institute of Ohio.

“Ohioans live less healthy lives and spend more on health care than people in most other states,” according to the Dashboard.

Ohio has consistently ranked near the bottom on health value in each of the four editions of the Dashboard. Ohio’s overall health value ranking was 47 in 2014, 46 in 2017 and 46 in 2019. 

The Dashboard found that Ohio’s healthcare spending is mostly on costly downstream care to treat health problems. This is largely because of a lack of attention and effective action in the following areas:

  • Children. Childhood adversity and trauma have long-term consequences
  • Equity. Ohioans with the worst outcomes face systemic disadvantages
  • Prevention. Sparse public health workforce leads to missed opportunities for prevention

The Dashboard is a tool to track Ohio’s progress toward health value — a composite measure of Ohio’s performance on population health and healthcare spending. In ranked profiles, the Dashboard examines Ohio’s rank and trend performance relative to other states across seven domains. In addition, through a series of equity profiles, the Dashboard highlights gaps in outcomes between groups for some of Ohio’s most systematically disadvantaged populations.

The Dashboard includes examples of nine evidence-informed policies that could be adopted by Ohio policymakers and private-sector partners to make Ohio a leader in health value.


1 in 5 U.S. adults report experiencing discrimination in healthcare system

A new national survey has found that one in five adults in the United States faces discrimination when accessing the healthcare system (Source: “Study: 1 in 5 U.S. adults subjected to race, gender bias in healthcare system,” United Press International, Dec. 15).

According to an analysis published Tuesday by JAMA Network Open, nearly two in five participants in a survey of more than 2,100 people reported they experienced racial and ethnic discrimination when seeking medical care, making it the most common form of bias, the data showed.

More than one in 10 participants reported being discriminated against based on their education or income level when they visited a doctor's office or went to the hospital. And roughly one in 10 reported experiencing bias based on their body weight, were discriminated against based on their gender or experienced age discrimination, according to the researchers.

"Discrimination is not uncommon in healthcare," study co-author Paige Nong, a doctoral candidate in sociology at the University of Michigan, told UPI. "We want our findings to show people who have experienced this kind of discrimination, which is often isolating and difficult to process, that that they are not alone."


HHS finalizes price transparency rules

Health insurers will be required to publicly post, in advance, the price for the most common services and procedures, under a rule finalized by the federal Department of Health and Human Services on Thursday (Source: “New Trump policy will force insurers to disclose prices up front,” The Hill, Oct. 29).

Patients will eventually have access to new information about cost, including an estimate of their cost-sharing liability, through an online self-service tool. Currently, this is information that patients typically receive only after they get those services, through an explanation of benefits form.

Beginning in 2022, insurers will be required to make available data files on the costs of various procedures, to better allow for research studies, and to help developers design tools to let patients compare costs across insurance plans. The requirement will take effect for 500 of the "most shoppable" services beginning in 2023, and then for all services starting in 2024.