Every North Carolinian deserves great health, but not every North Carolinian has access to the tools they need to achieve it. North Carolina hospitals and health systems are committed to eliminating health disparities so that everyone has access to high quality care.
Five regional healthcare leaders came together in a virtual town hall to discuss steps being taken to accelerate health equity in North Carolina. Panelists are members of the Equity Committee and represent hospitals and health systems who have signed the Equity of Care Resolution.
The conversation is part of a series of virtual town halls hosted by the North Carolina Healthcare Association.
Panelists featured Roxie Wells, MD, President of Cape Fear Valley Hoke Hospital; Mary Jo Cagle, MD, Chief Executive Officer, Cone Health; Fernando Little, Vice President, Chief Diversity Officer, Atrium Health; Frank Emory, EVP & Chief Administrative Officer, Novant Health; and Kerry Watson, Principal, Watson Healthcare Management Solutions.
Here are some of the key takeaways from the conversation:
Defining health equity
Health equity can take on a different meaning from hospital to hospital, although most agree that it starts with the individual patient, learning their needs and addressing what barriers may impede them from receiving equitable care.
“Regardless of the thing that makes each of us different, [it is important] that they can get healthcare of high quality with good outcomes,” said Dr. Mary Jo Cagle, Chief Executive Officer of Cone Health.
Dr. Cagle explained that many varied factors may impact the patient’s health, but health care providers should be able to address the patient’s needs when they need care.
Fernando Little, Vice President and Chief Diversity Officer at Atrium Health referenced transformative equity, which looks at the barriers in place that are stopping individual patients from receiving equitable care. Some of those barriers could stem from socio-economic status, residential environment (rural, suburban, or urban settings), race, gender, etc. The panelists agreed healthcare organizations must work to remove those barriers.
Learn more about health equity initiatives in North Carolina.
Medicaid expansion promotes equitable care
North Carolina is one of just 11 states that have not yet expanded Medicaid.
Medicaid expansion would open the door for many North Carolinians to have access to the affordable health care they deserve. Frank Emory, Executive Vice President and Chief Administrative Officer of Novant Health, explained Medicaid Expansion helps patients, providers and communities.
“It makes health care more affordable to them (patients), thereby making them healthier, their families healthier which allows us to take better care of our communities,” said Emory.
Mr. Emory also noted that better funding through Medicaid expansion provides better access for people with behavioral health issues. Expanding Medicaid would help these populations gain access to more providers so they can get the essential care they need. From his perspective, there is a straight line between Medicaid expansion and better care for populations suffering from behavioral health issues.
The North Carolina General Assembly has the opportunity to include Medicaid expansion in next year’s state budget. Passing Medicaid expansion in 2023 would help the 600,000 North Carolinians that are currently in the coverage gap.
Learn more: N.C. General Assembly – Close the Coverage Gap in 2023
Addressing disparities in care delivery
Health disparities in clinical care are measurable, identifiable, and addressable through straightforward action steps to ensure that all patients receive quality health care. North Carolina is leading the nation in targeting inequities in care delivery from an association standpoint by focusing on quality metrics that will drive meaningful change.
As a first step, NCHA member hospitals and health systems have been invited to sign an Equity of Care Resolution. Dr. Cagle explained that by committing to the Resolution, North Carolina hospitals and health systems can work together to achieve equity of care in a clinical setting by reducing harm events and addressing bias in care delivery.
“We have the opportunity to learn from each other and accelerate improvement. There is power in the sharing [of data] across the continuum of our state,” said Dr. Cagle.
As of today, 86% of NCHA member hospitals and health systems have signed the Resolution. The NC Equity of Clinical Care Dashboard, launching this month, will display a statewide view of the progress hospitals and health systems are making to improve health equity, on the NCHA website through a secure log-in. Next year, improvement work will begin.
Creating a more diverse healthcare workforce
Hospitals and health systems across North Carolina are developing initiatives to train and inspire a more diverse healthcare workforce.
One way that hospitals and health systems are creating a diverse pipeline of talent is through partnership programs with local schools. Dr. Wells mentioned that Cape Fear Valley has partnered with Fayetteville State University, a local HBCU, to provide paid internships for students interested in healthcare careers.
Similarly, Mr. Little discussed Atrium Health’s Rise to Success program, which enables high school graduates to earn an Associate degree or certification in a healthcare-related discipline from a local community college.
Mr. Emory mentioned Novant Health’s work with Black Men in White Coats. The healthcare system hosted its first Youth Summit in 2022. The initiative aims to encourage young Black students, middle school through high school, to pursue careers in medicine, both clinical and non-clinical.
On a statewide level, the North Carolina Healthcare Foundation Diverse Healthcare Leaders Mentorship Program aims to build a diverse pipeline of underrepresented men and women into healthcare leaders that will shape and transform health in NC. Right now, you can help amplify the impact of this program by donating to NCHF’s Fall Giving Campaign.
Learn more: Inspiring a diverse healthcare workforce
Addressing unconscious bias in healthcare
More healthcare systems are starting conversations around diversity, equity and inclusion (DEI) which addresses the unconscious bias that may arise. This may be seen in small ways like an interaction with a patient in the hallway or a discussion with a patient about a bill. Unconscious, or implicit bias, can start small but trickle down and impact the healthcare system, especially in patient care.
Kerry Watson, Principal of Watson Healthcare Management Solutions, expressed the responsibility to address unconscious biases falls on everyone within a healthcare system.
“All of us acknowledged that we have our own unconscious bias and those unconscious biases for everyone who touches a patient, who may not touch a patient, who’s working in the background, will result in assumptions that lead to biases, that lead to stereotypes, that lead to discrimination in some form of process,” Mr. Watson said.
To move forward, it is critically important that all leaders and staff take accountability and address those unconscious biases and awareness. Mr. Watson suggests training, observations and collectively assuming responsibility to call out unconscious biases as a start to solution.
