Can Virtual Health Trigger a More Equitable Medicaid Climate? | Deloitte US has been saved
By David Betts, principal, Public Health Transformation, Deloitte Consulting LLP
Over the holidays, I took part in the experience of a lifetime…a National Geographic expedition cruise to Antarctica! We didn’t encounter many people, but we did see lots and lots of penguins. I learned there are seven species native to Antarctica. These flightless birds exist in the harshest environment on the planet. In the water, they are hunted by killer whales and leopard seals.1 On land, they face ever-changing living conditions, an uncertain food supply, and a shifting landscape that appears impossible to navigate.
I was recently describing the trip to my colleague (and penguin enthusiast) Alison Muckle Egizi, health policy research lead at the Deloitte Center for Government Insights. We started to see some strong parallels between what I experienced in Antarctica and the harsh conditions and stress that many people in the US endure every day. Financial insecurity, unstable housing conditions, exposure to violence, polluted air and water, unpredictable access to healthy food, and other drivers of health can be detrimental to both physical and mental health (see Addressing the drivers of health). And when health needs arise, Medicaid enrollees sometimes must traverse a health care landscape that can seem impossible to navigate. Our latest research explores how virtual health within a value-based care (VBC) framework could help make high-quality care more accessible and equitable for all Medicaid enrollees (see Leveraging virtual health within a VBC framework).
About 83.9 million people across the United States are covered by Medicaid—roughly 25% of the population.2 States and Medicaid managed care plans are well positioned to help enrollees navigate the health care system and use technology and alternative sites of care to improve access (see Advancing health through alternative sites of care). VBC models are becoming more common among commercial health plans and large, self-insured employers. (see Aligning on value-based care). In addition, several states have adopted VBC models for their Medicaid programs.
Four barriers that can contribute to health inequities
Uncertain and limited access to resources, combined with impaired decision-making, can lead to poor health outcomes—for both penguins and people. Here is a look at some of the barriers that can contribute to health inequities among Medicaid enrollees and how virtual health and a VBC model could address some of those challenges:
A penguin’s health is closely tied to its environment just as the drivers of health influence the well-being of Medicaid enrollees. Penguins demonstrate that even in conditions of extreme unpredictability and scarcity, they can overcome seemingly insurmountable obstacles and survive…maybe even thrive. Virtual health within a VBC framework could help make high-quality health care more accessible and equitable for Medicaid enrollees. Providing enrollees with virtual tools that meet their needs—and helping them stay more connected to community-support networks—could help them to take a more active role in their health and stay connected to health care providers.
Acknowledgements: Alison Muckle Egizi, Leslie Korenda, James Howgate
1 Penguins – Australian Antarctic Program
2 September 2022 Medicaid enrollment data, Medicaid.gov, September 2022
3 Medicaid and Rural Health, The Medicaid and CHIP Payment and Access Commission (MACPAC), April 2021
4 About Rural Health, Centers for Disease Control and Prevention, August 2, 2017
5 Health in Rural America, National Institutes of Health, March 2022
6 Emperor Penguins in Antarctica, coolantarctica.com
7 An evaluation of telehealth use by Medicare beneficiaries, Institute for Healthcare Policy & Innovation, University of Michigan
8 Scientists Report a Dramatic Drop in the Extent of Antarctic Sea Ice, Inside Climate News, January 6, 2023
9 Emperor Penguin Gets Endangered Species Act Protections, US Fish & Wildlife Services, October 25, 2022
10 FACT SHEET: The Biden-Harris Administration Announces More Than $8 Billion in White House Conference on Hunger, Nutrition, and Health, September 28, 2022
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David Betts is the leader for Public Health Transformation for Deloitte Consulting. He focuses on assisting clients in the public health arena to create a more resilient public health infrastructure building on lessons learned in the pandemic. Betts brings more than 17 years’ experience working with clients in the private sector health care industry where he drove significant transformations focused on creating a more human-centric health care system. Betts holds a BA from the University of California, a master’s degree from The University of Texas at Austin, and an MBA from the Tepper School of Business at Carnegie Mellon University.