South Florida Hospital News
Monday August 19, 2019
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September 2005 - Volume 2 - Issue 3

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Aetna’s Approach to Addressing Racial and Ethnic Disparities in Health Care

The population of racial and ethnic minorities in the U.S. is larger than ever, and it’s continuing to grow at a rapid pace. This increasing diversity is having a significant impact on the health care industry – opening up new opportunities for health benefits companies who can provide culturally appropriate services and products.

It’s also bringing the issue of health care disparities into sharper focus. At Aetna, our goal is to provide as many people as possible with access to quality health care, regardless of race or ethnicity. Studies show that certain populations are predisposed to certain health risks, conditions and diseases in higher numbers than others. Our sophisticated data collection and identification processes help us in the ongoing development of preventive care and disease management programs targeted to these at-risk members.

For instance, African-American women have consistently higher rates of premature delivery than do white women, even when considering other sociodemographic factors such as educational level, income and insurance status.1 In fact, premature birth is the leading cause of neonatal death in African-Americans and the second-leading cause of infant death among all Americans of all races.2

Our Preterm Labor Education Program helps women reduce their risk of preterm labor and delivery by providing at-risk mothers with education and preterm labor identification services early in pregnancy. Services include instruction on the signs and symptoms of preterm labor, information about new treatment options and telephone follow-up by registered nurses.

Hispanic and African-American women encounter several barriers that prevent them from getting annual mammogram screenings. Through our Breast Health Disparity Initiative, we identify African-American and Hispanic-American women age 40 and over who have not had their annual mammogram. We then provide culturally sensitive telephone outreach from a bilingual nurse case manager, who addresses members’ individual risk factors and barriers to obtaining this essential screening. In 2004, more than 3,600 at-risk women were identified and contacted.

Voluntary Member and Physician Data Collection

Experts agree that one of the most important things a health insurer needs to do to help reduce health care disparities is to know the race and ethnicity of each member. Aetna is a leader in the collection of race, ethnicity and language preference data on a voluntary, self-identification basis from members. This helps us create more culturally focused disease management and wellness programs. It also allows us to identify disparities, support and encourage new research, and test new approaches to reducing disparities in health care.

Today, more than 1.7 million of our members have provided this information on their enrollment forms or through our Aetna member website, Aetna Navigator. Our success in overcoming the perceived barriers to collecting race and ethnicity data is a result of clear communication with employers and members about the significance of this information and how it will be used.

The concept of cultural competency is based on knowledge and respect for others’ beliefs and traditions. In some ethnic or racial groups, complex cultural beliefs may influence whether a person seeks medical care or follows through on medical advice from his or her physician.

We actively support doctors in the Aetna network in understanding different cultures and developing skill in asking the right questions. A secondary data collection initiative is focused on understanding the race, ethnicity and languages spoken by Aetna’s network of participating physicians. In order to serve the needs of our diverse membership, it is important for us to develop a network that reflects the racial and ethnic composition of our member populations. We also offer training and educational materials on cross-cultural care, and we promote more culturally focused communications between physicians and their patients.

Furthermore, over 95 percent of our clinical professionals have completed a cultural competency training program to increase awareness of cultural disparities and improve the way we assist members in navigating the health care system.

English and Spanish Tools and Resources for Members

Many of our member education tools are available in both English and Spanish, including:

  • Our Aetna Navigator member website, which provides access to important health information, personalized claims status, benefits plan details and self-service features, including the ability to send and receive emails in Spanish.
  • Our DocFind®online directory of health care professionals and facilities, which allows members to search by specialty, location and languages spoken.
  • Our 24-hour Informed Health® Line telephone service, where registered nurses provide members with information on more than 5,000 health-related topics.
  • Member health education and disease management materials.
  • Health information on the Aetna InteliHealth® consumer website.
Over the past two years, our coordinated, multi-dimensional approach to addressing racial and ethnic disparities has enabled us to improve the health benefits and services available to our increasingly diverse membership and influence the quality of care that these members access. Buoyed by this progress, we continue to look for ways to further benefit our at-risk members. We are confident that our efforts to better serve at-risk members may benefit all Aetna members, because reducing the disparities in health care could ultimately improve care for everyone and reduce overall health care costs.
1 Ventura SJ, Martin JA, Currin SC, Menacker F, Hamilton B. Final data for 1999. National Vital Stat Rep. 2001; 49:78-9

2 The March of Dimes and the U.S. Department of Health and Human Services: Partners in Preventing Birth Defects and Infant Mortality, March of Dimes Leadership Conference, October 17, 2003.

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