Highmark Creates Multi-Dimensional Approach To Address Health Care Disparities

Solutions Help Provide Increased Quality Of Care For All

April 29, 2008

PITTSBURGH -- In 2002, the Institute Of Medicine (IOM) published Unequal Treatment: Confronting Racial and Ethnic
Disparities in Health Care, a report that concluded racial and ethnic minorities receive lower-quality health care than whites, even when they are of similar age, at a similar income level and have the same access to health coverage and care.

Although the quality of health care is poor for many Americans, specific racial and ethnic groups continue to experience worse quality care than their white counterparts. Evidence of these disparities in treatment is strongest for African-Americans and Hispanics in the U.S., but is also growing among American Indians.

Highmark Inc. has formed a multi-dimensional approach to focus on health care disparities, and has been addressing this issue for more than five years through activities including data collection; focused interventions by the Integrated Clinical Services division; programs by the Community Affairs division; Highmark Foundation programs aimed at improving community health; and national initiatives that are designed to reduce disparities and improve the quality of care for all.

"With strong support from senior management, Highmark is taking a comprehensive approach to address health care disparities," said Rhonda Moore Johnson, M.D., medical director of integrated clinical services at Highmark. "Highmark takes its obligation seriously. We know we have opportunities to close some gaps in health care quality among our racial and minority group members. Our comprehensive strategy includes working with our providers, our health care systems, our members and our communities to improve health care quality and access. We want all of our members to live longer, healthier lives. "There are many possible reasons for these disparities, including access to high-quality care; cultural and language barriers; health literacy barriers; limited cultural competence of providers and health care organizations; biases; prejudices and stereotypes that may affect the way providers render care; and lack of trust by minority patients for the health care establishment.

Highmark invests in reducing health disparities: 

In 2006, Highmark formed a multi-disciplinary committee that oversees programs and practices that address the needs of an increasingly diverse population and marketplace.

Cultural competency training was completed by all Highmark medical directors and more than 1,000 Highmark clinical staff and customer service representatives. Also, nearly all of Highmark's 19,000 employees receive diversity and inclusion training on an ongoing basis.

Through significant grant making, Highmark supports a number of outreach programs and local organizations throughout Pennsylvania. Highmark provided corporate giving funding to the Children's Sickle Cell Foundation in Pittsburgh, the Latino Leadership Alliance of the Lehigh Valley, and the Pennsylvania Immigrant & Refugee Women's Network. Highmark has also created special educational events: Partners for a Healthy Community, daylong events that offer free health screenings; and Fun, Fit and Fabulous!, conferences for women and teens of color.

The Highmark Foundation, a charitable organization and private foundation funded solely by Highmark Inc., provided funding to Capital Region Health System at Hamilton Health Center for their Healthy Outcomes program for diabetic patients and to Washington County Health Partners (WCHP) to help launch the Health Ministry Initiative, which is a program to identify and address the health issues of African-Americans in Washington County. The foundation has also provided several grants for dental and oral health programs across the state.

Information on Highmark preventive health support programs and other resources, as well as reminders for colorectal cancer screening, were mailed to minority members. As to another initiative, a 14 percent increase in flu vaccination rates was noted among Highmark's African-American members from 2005 to 2006. Highmark is working with members to obtain self-identified race, ethnicity and language preference data through voluntary, confidential questionnaires and Interactive Voice Recognition telephone outreach. Highmark has received a 30 percent response rate from members.

Through Blues On Call, Highmark addresses health disparities with customized outreach materials. The Highmark population is segmented, so that individual members receive direct mail with targeted messages based on clinical needs and socio-demographic variables such as age, geographic location, socio-economic status, literacy, and race/ethnicity.

Highmark has worked with the SilverSneakers program to improve access to fitness facilities by adding three additional centers in Pittsburgh's East Liberty, Wilkinsburg and Hill District neighborhoods.

Highmark has been engaging practicing physicians through newsletters, focused discussion groups, quality management physician subcommittees and focused educational interventions. An external advisory panel was created in 2007 that includes physicians and local and national experts to provide guidance and recommendations to improve quality health care.

Highmark is one of 11 national health plans participating in the National Health Plan Collaborative to Reduce Disparities and Improve Quality funded by the Robert Wood Johnson Foundation and the Federal Agency for Health Care Research and Quality.

"Reducing health care disparities is important to Highmark, as well as a key focus of the federal government and the U.S. Department of Health and Human Services' Healthy People 2010 disease prevention and health promotion objectives," said Johnson. "Highmark will continue to take an active role in reducing racial and ethnic health care disparities. Developing and
implementing strategies to reduce or eliminate disparities will require Highmark to develop more effective communication tools and strategies to interact with a diverse pool of members."

About Highmark Inc.
As one of the leading health insurers in Pennsylvania, Highmark Inc.'s mission is to provide access to affordable, quality health care enabling individuals to live longer, healthier lives. Based in Pittsburgh, Highmark serves 4.6 million people through the company's health care benefits business. Highmark contributes millions of dollars to help keep quality health care programs affordable and to support community-based programs that work to improve people's health. Highmark exerts an enormous economic impact throughout Pennsylvania. A recent study states that Highmark's positive impact exceeded $2.5 billion. The company provides the resources to give its members a greater hand in their health. Highmark Inc. is an independent licensee of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield Plans. For more information, visit http://www.highmark.com.