Health disparities are preventable differences in health outcomes that are experienced by disadvantaged populations. They are a leading factor in the incidence, prevalence, mortality, and burden of health conditions across specific populations in the US. These factors can influence the available health services and outcomes of care, and should be monitored across age, gender, race and ethnicity, language and disability, and the communities where people live. Optum has demonstrated a commitment to monitoring and addressing these components of health and well-being across provider networks and services.
An essential goal for Optum is to reduce health disparities and improve the quality of health outcomes and overall well-being of consumers and their communities. This can be achieved in part through cultural competency, including a commitment to embracing diversity, monitoring health services for disparities, and creating culturally sensitive programs, initiatives, and health resources that foster health and recovery.
The Substance Abuse and Mental Health Services Administration (SAMHSA) cites the importance of cultural competence as: “the ability to interact effectively with people of different cultures, [which] helps to ensure the needs of all community members are addressed. Cultural Competence means to be respectful and responsive to the health beliefs and practices—and cultural and linguistic needs—of diverse population groups. Developing cultural competence is also an evolving, dynamic process that takes time and occurs along a continuum (“SAMHSA’s Strategic Prevention Framework: Cultural Competence,” http://www.samhsa.gov).” Additionally, SAMHSA cites culturally competent organizations as continually assessing their organizational diversity; investing in the development of inclusion and cultural competency; utilizing strategic planning that incorporates community culture and diversity; implementing prevention strategies that use culture and diversity as a resource; and, continually evaluating the incorporation of cultural competence. Culturally proficient organizations partner with others to promote and advocate for services that meet the needs of all populations.
Optum is committed to the principles of health equity and cultural competency, and involves staff at all levels to monitor, educate, and address diversity issues across clinical and network operations, customer services, and quality management. In behavioral health, the challenges of health disparities are uniquely important and can lead to increased stigma and isolation associated with these conditions. Additionally, these issues can also complicate the integration of care for physical and behavioral health conditions.
In the development of clinical networks of care, Optum recommends assuring cultural competence across all service levels. The pathways to address diversity, health equity, and cultural competence vary depending on the state of development or transformation of existing networks of care. In all cases cultural competence should be guided by a set of principles that include the ability of service systems to provide care to covered members who may have diverse values, beliefs, and behaviors. Services must be tailored to meet an individual’s social, cultural, and linguistic needs. These goals are achieved through an ongoing process that includes:
Analytics – the ongoing review of the covered population for demographics and likely disparities that may influence health outcomes including: age; gender; address; race and ethnicity; language; and other factors.
Stakeholder Awareness– Providing all clinical and non-clinical staff education and training on cultural competency. This fosters a recognition and awareness of the unique needs of covered members from various diversities including culture, race, ethnicity, sexual identity and gender preference, and other factors. This supports the delivery of more personalized and responsive services.
Member Outreach and Engagement – It is important to develop and provide health information and plan resources that recognize the unique cultural and diversity needs of the covered population. These should help support member engagement in health care services and reduce gaps that may be based on cultural diversity issues that can impact health outcomes.
Provider Education and Technical Assistance – In the development of provider networks and systems of care, it is important to recognize issues of both the diversity of providers and the populations they serve. Providing ongoing educational and training resources for providers helps them to better understand issues of health disparities and to deliver culturally competent care. This also assures that all providers have access to understanding the unique attributes of the populations they serve.
Some examples of how Optum applies these recommendations for culturally diverse and competent care can be seen in several different markets. In New York, Optum has partnered with the New York Association of Psychiatric Rehabilitation Services (NYAPRS) to offer peer support services that help covered members who transition from psychiatric hospitalization to their home communities. In this program peer support specialists trained by NYAPRS work to promote community integration and support community tenure by helping members re-engage within their communities following an admission. A key to this program is the peer specialist’s ability to recognize the unique attributes of an individual’s culture and community and help support their engagement in care and foster their recovery in the community.
In another example, Optum has worked with San Diego County to develop a 24/7 crisis line that gives all covered members access to urgent and emergent resources that meet the needs of the entire community. The staff in this resource are trained in cultural diversity to meet the unique social and cultural needs of those it serves. In addition, Optum has provided educational services to the community on the Seeking Safety model of suicide prevention. This approach fosters a safe environment for those of diverse backgrounds to address past traumas. Working collaboratively with the Healthy San Diego Behavioral Health Workgroup, Optum has recognized the diverse populations served to prepare for the implementation of Medicaid expansion and the development of the Medi-Cal Mental Health Severity Screening Tool.
It is vital to provide person-centered care to all of the people we serve. This approach recognizes that each individual has a unique set of personal characteristics and attributes. Care provided must be responsive and respectful of these needs. These include social, cultural, and health specific factors that influence how our members become engaged in health care, and how they activate healthy behavior change and management to achieve positive health outcomes. Cultural diversity and health equity influence how systems of care must respond to these individual factors. Optum recognizes that this is a system-wide challenge that must be addressed by all involved staff, network providers and facilities, and resources that impact health outcomes.
NOTE: Optum does not recommend or endorse any treatment or medications, specific or otherwise. The information provided is for educational purposes only and is not meant to provide medical advice or otherwise replace professional advice. Consult with your clinician, physician or mental health care provider for specific health care needs, treatment or medications. Certain treatments may not be included in your insurance benefits. Check your health plan regarding your coverage of services.