2024 Outlook for Health Equity Health equity leaders may play an increasingly critical role

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By Jay Bhatt, D.O., managing director of the Deloitte Health Equity Institute and the Deloitte Center for Health Solutions, and Maningbè B. Keita Fakeye, Ph.D., health equity research manager, Deloitte Services, LP

Over the past year, we have had in-depth health-equity conversations with many health care and life sciences executives, and we have participated in quite a few conference panels on the subject. Based on our conversations, it’s clear that health equity continues to be seen as a business strategy. We have also heard that being a health equity leader can be a lonely job. It shouldn’t be.

More than 80% of C-suite executives from life sciences and health care organizations see improved health equity as a top-10 goal for 2024, and nearly 50% expect to increase health equity investments next year, according to surveys conducted by the Deloitte Center for Health Solutions. (See the 2024 Outlook for Health Care and the 2024 Outlook for Life Sciences.)

While most industry leaders we have spoken to see value in ensuring that everyone has access to high-quality health care, realizing a return on the investment (ROI) requires an intentional strategy and time. In the short term, health equity investments could impact the nature of competition if it has a favorable effect on recruitment, retention, or operations. In the long-term, health equity can affect every aspect of business—from an organization’s workforce to its products and services. It can be the differentiator in value and growth. As a business imperative, health equity should be embedded in leadership teams and throughout every organization. Health equity leaders can be instrumental in coordinating those efforts. As care continues to shift from reactive to restorative and preventive, health equity could become even more important.

Headwinds and tailwinds for 2024

We recently surveyed health equity leaders from health systems, health plans, pharmaceutical companies, medical device manufacturers, advocacy groups, and technology organizations to learn more about some of the challenges they face, and to find out what they expect for the year ahead (Click here to see results from the 2024 Health Equity Outlook survey).

More than half of surveyed health equity leaders (53%) expect regulatory pressure to be a driving force in their strategy next year. States, federal agencies, trade associations, accrediting bodies, and the White House have made health equity a priority for health care and life sciences organizations (see Health Equity is becoming a regulatory reality.) More than 40 states have expanded or planned initiatives to address racial and ethnic disparities in their Medicaid programs. They intend to focus on a broad range of disparities including mental and behavioral health, maternal health, cancer, and other chronic conditions.¹ In addition, some payers are evaluating the impact food-as-medicine, and other drivers of health, can have on health care costs.²

Some regulatory agencies and accrediting bodies are also paying more attention to health equity. The US Food and Drug Administration (FDA) said it will require researchers—and companies seeking approval for late-stage clinical trials—to submit a plan that ensures diversity among trial participants.³ (See our report, Enhancing diversity in clinical trials.) In July, the Joint Commission introduced a new leadership standard that requires accredited hospitals, health systems, and other organizations to collect race and ethnicity information from patients. It also adds new requirements to help prevent discrimination among individuals who work in ambulatory and behavioral health care settings.⁴

Nearly half of our survey respondents (49%) said they expected that an increased focus on patient engagement and outcomes would be another force pushing health equity initiatives forward in 2024. Health inequities already cost Americans an extra $320 billion a year in avoidable health care costs, which include poor outcomes. Unless this changes, that expense is expected to triple to $1 trillion by 2040—about $3,000 a year for every person (see The economic cost of health disparities). Along with reducing overall health care costs, a solid health equity strategy could help organizations strengthen relationships with consumers, which could help to increase market share (see Health equity in life sciences). 

Survey respondents also expect some headwinds in the year ahead. These potential challenges include limited resources, competing priorities, and margin pressures. Setting goals—and being able to accurately measure progress toward meeting those goals—could help overcome these challenges. More than half of survey respondents (55%) said having a well-defined way to measure and evaluate health equity was a strategic priority for 2024.

5 factors likely to influence health equity initiatives in 2024

We define health equity as the fair and just opportunity for everyone to achieve their full potential in every aspect of their health and well-being regardless of race, gender, ability status, or ZIP code (see An agenda of equity in health). Now that the dust has settled from the COVID-19 pandemic, the next evolution in health care should reflect the reality that the previous normal did not work for everyone. The U.S. health care system wasn’t built for everyone, but that model appears to be changing. Alternative care sites, virtual health, and devices that allow for remote patient monitoring could help meet the needs of more Americans (see Advancing health through alternative sites of care). In addition, health insurance options specific to the health needs of the LBGTQIA+ community,⁵ or innovative insurance policies focused on women’s health, could help payers improve the health of more members.⁶ Employed women collectively spend $15.4 billion more a year than men in out-of-pocket health care expenses, according to our recent research (see Hiding in plain sight: The health care gender toll).

Here are five more factors that could help ensure that health equity is a part of the next normal:

1. Artificial intelligence (AI): Many life sciences companies are already integrating generative AI into their workflows (see Can life sciences companies unlock the full value of GenAI?). Health care and life sciences executives should ensure the technology does not create unintended biases. On October 30, President Biden signed an Executive Order (EO) on AI that outlines regulatory actions federal agencies should take now.⁷ While EOs are not law, they help guide federal agencies as they develop and release guidance. Over 80% of surveyed health equity leaders said they currently have low or no involvement in decision-making processes for their organization’s AI strategy. That is likely to change if AI becomes a more integrated part of health care delivery. We see generative AI as the latest step along the journey toward Deloitte’s vision of the Future of Health^TM, which we first outlined in 2019. The health equity lens that leaders apply to AI can be the difference between scaled improvements and exponential deterioration. The global AI regulatory landscape is dynamic and rapidly evolving. We will work to help organizations so they can stay updated and engaged with the latest trends and best practices. (See the Deloitte AI Institute’s Generative AI Dossier to explore use-cases across six industries, including life sciences and health care).
   
2. Community engagement and clinical trials: Sixty percent of surveyed health equity leaders said increasing community engagement and collaboration is their top priority for 2024. Such relationships can be important for building and sustaining trust. Some organizations view community engagement as a cost, but it should be seen as an asset (see Advancing health equity through community-based ecosystems). For example, forging strong ties with community health centers could help biopharmaceutical companies improve diversity in their clinical trials. With their commitment to patient-centered care across diverse patient populations, community health centers generally represent an untapped potential for driving equitable participation in clinical research. According to recent data conducted by the Deloitte Center for Health Solutions and the National Association of Community Health Centers (NACHC), 43% of community health centers are conducting and/or are interested in conducting clinical trials in the future (see Broadening research participation through community engagement). However, several structural challenges should be addressed for this potential to be realized.
   
3. Workforce: Almost 40% of surveyed health equity leaders said they expect workforce recruitment, retention, and burnout to be a major challenge for their organization’s health equity initiatives. Organizations might consider expanding their recruitment efforts to include the communities they serve. That could help organizations build trust by creating a workforce with a broader lived experience. In addition, focusing on the health and wellbeing of employees could help improve retention, reduce burnout, and improve productivity. C-suite executives surveyed from both the life sciences and health care sectors agreed that workforce wellbeing would be a priority in 2024. Organizations should look for ways to monitor their well-being efforts through an equity lens (see New resource gives business leaders a blueprint for optimizing equitable employee health and well-being). Our recent research determined that employers are positioned to play a key role in helping employees live longer, healthier lives—adding as many as 20 additional healthy years. Connecting workforce efforts to retention, productivity, and wellbeing can further drive home the value of health equity (see Employers can spark healthy aging).
   
4. Ecosystem collaborations: Some health equity leaders are prioritizing collaborations with key players to help advance health equity across the broader ecosystem, according to our health equity survey results. We continue to see potential in bringing public and private sector organizations together for place-based change to advance health equity.⁸ Ecosystem collaborations could be an opportunity to drive value and growth through new and innovative engagements. Many CEOs from across sectors and around the globe have committed to taking action on health equity. Deloitte Global is a founding signatory of the Zero Health Gaps Pledge, a global, multi-sector, CEO-level commitment to help advance health equity. The Pledge was launched by the Global Health Equity Network at the 2023 World Economic Forum Annual Meeting in Davos, Switzerland.
   
5. Research capabilities: More than half of surveyed health equity leaders (55%) said their research strategy would be a high priority for 2024. The importance of reliable data and accurate measurements are likely to grow in importance as organizations prioritize health equity as a core function. Strengthening data quality, community engagement, and multisectoral collaborations might facilitate key sector outcomes. When asked about the biggest challenges impeding their ability to measure, evaluate or conduct research, health equity leaders pointed to outdated data infrastructures, data standardization/interoperability challenges, and limited collaboration/data sharing.
   

Health equity is at a critical juncture with important challenges that need to be overcome. But we are optimistic that health care and life sciences organizations are on the right path as they head into 2024. Innovative approaches to corporate philanthropy, such as The Deloitte Health Equity Institute, can help organizations advance their moral and business imperative. The Institute works to address root causes of health inequities through collaborations that can allow organizations to strengthen place-based change, drive health equity innovation, and equip key decision makers. Our philanthropic and pro bono work supports non-profit organizations addressing areas with the largest disparities across race, ethnicity, income, gender, and age (see Whitman-Walker’s DEI focus helps weave a tapestry of humanity and Meet New Profit’s 2023 mental health equity catalyze cohort).

Being a health equity leader can be a lonely job, but it doesn’t have to be. Health equity leaders tend to play a significant role in decision-making processes that involve community health partnerships, growth, and innovation. As organizations lean into health equity, we expect more illnesses will likely be prevented and more patients can experience better health outcomes, which could have a dramatic effect on overall health care spending.

As health equity continues to be incorporated into business strategies, the role of the health equity leader is likely to only grow in importance.

Acknowledgments

Thank you to our Chief Health Equity Officer, Dr. Kulleni Gebreyes, and our National Industry Leader, Dr. Asif Dhar. We would also like to acknowledge the teams from the Deloitte Center for Health Solutions and the Deloitte Health Equity Institute, including Richa Malhotra, Nivedha Subburaman, Gargi Khandelwal, and Pavan Bhoslay Kumar for their work in research management, design, analysis, and interpretation. We would also like to thank Steve Davis for his writing and editorial support.

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Endnotes:

^{1_{Medicaid and racial health equity, Kaiser Family Foundation, June 2, 2023}}

^{2_{Enhance EQUITY Initiative, U.S. Food & Drug Administration, June 1, 2023}}

^{3_{Association of national expansion of insurance coverage of medically tailored meals, Journal of the American Medicine Association, October 3, 2022}}

^{4_{Advancing health equity, The Joint Commission}}

^{5_{SCAN creates MA plan for LGBTQ+ seniors, MedCity News, October 18, 2022}}

^{6_{Insurer cuts name-brand drug costs, starts women-focused MA plan, Fierce Healthcare, October 2, 2023}}

^{7_{President Biden issues Executive Order on safe, secure, and trustworthy AI, The White House, October 30, 2023}}

^{8_{Health equity requires collaboration beyond health care organizations, Philadelphia Business Journal, July 10, 2023}}

This publication contains general information and predictions only and Deloitte is not, by means of this publication, rendering accounting, business, financial, investment, legal, tax, or other professional advice or services. This publication is not a substitute for such professional advice or services, nor should it be used as a basis for any decision or action that may affect your business. Before making any decision or taking any action that may affect your business, you should consult a qualified professional advisor.

Deloitte shall not be responsible for any loss sustained by any person who relies on this publication.

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