Coverage that Cares: Health Equity

The Importance of Health Equity Accreditation

The NCQA Health Equity Accreditation is a rigorous and actionable framework designed to help healthcare organizations identify and address barriers to equitable care. By meeting the stringent criteria set forth by the National Committee for Quality Assurance (NCQA), WellCare of North Carolina has demonstrated its ability to:

• Collect and analyze data on the social determinants of health that impact its members
• Develop and implement targeted interventions to address identified health disparities
• Engage with community partners and stakeholders to foster collaborative solutions
• Cultivate an internal culture that prioritizes diversity, inclusion, and cultural competency
• Continuously monitor and improve its efforts to promote health equity

This accreditation not only recognizes WellCare's achievements, but also serves as a blueprint for other healthcare organizations to follow in their pursuit of equitable, high-quality care.

WellCare's Holistic Approach to Health Equity

At the heart of WellCare of North Carolina's health equity efforts is a deep understanding that improving health outcomes requires a multifaceted approach. The organization has adopted a comprehensive strategy that encompasses both internal and external initiatives, all aimed at addressing the complex web of social, economic, and environmental factors that contribute to health disparities.

Internal Initiatives: Cultivating a Culture of Equity and Inclusion

WellCare's commitment to health equity begins within its own walls, where the organization has made a concerted effort to foster a culture that values diversity, inclusion, and cultural competency. This includes:

• Diversity and Inclusion Training: Providing ongoing training and education for all employees to enhance their understanding of cultural differences, implicit biases, and the importance of delivering culturally-responsive care.
• Diverse Workforce: Actively recruiting and retaining a workforce that reflects the diversity of the communities it serves, ensuring that members have access to providers and staff who understand their unique needs and perspectives.
• Employee Resource Groups: Establishing employee-led resource groups that celebrate and support the diverse backgrounds and experiences of WellCare's team members, fostering a sense of belonging and empowerment.
• Leadership Commitment: Ensuring that health equity is a top priority at the highest levels of the organization, with executive-level oversight and accountability for driving progress.

By cultivating an internal culture that prioritizes equity and inclusion, WellCare is better equipped to translate these values into tangible, impactful initiatives that benefit its members and the broader community.

External Initiatives: Partnering for Systemic Change

While internal efforts are crucial, WellCare of North Carolina recognizes that addressing health disparities requires collaboration and partnership with a wide range of stakeholders. The organization has proactively engaged with employers, regulators, and community-based organizations to drive systemic change and improve health outcomes across the state.

Employer Partnerships

WellCare has forged strategic partnerships with employers to help them understand and address the unique health needs of their diverse workforces. This includes:

• Customized Health Plans: Developing tailored health plan offerings that incorporate culturally-responsive services and targeted interventions to address the specific challenges faced by each employer's employee population.
• Workforce Education: Providing educational resources and workshops to help employees better understand their health benefits and how to navigate the healthcare system effectively.
• Wellness Initiatives: Collaborating on comprehensive wellness programs that promote healthy behaviors and address the social determinants of health, such as access to nutritious food, safe housing, and transportation.

Regulatory Partnerships

WellCare has also forged strong partnerships with regulatory bodies, such as the North Carolina Department of Health and Human Services, to ensure that its health equity efforts are aligned with statewide priorities and initiatives. This includes:

• Compliance and Reporting: Proactively meeting and exceeding the health equity requirements set forth by the state, including the timely completion of the NCQA Health Equity Accreditation.
• Policy Advocacy: Engaging with policymakers to advocate for legislative and regulatory changes that support the advancement of health equity, such as increased funding for community-based programs and the expansion of Medicaid coverage.
• Data Sharing and Collaboration: Collaborating with state agencies to share data, best practices, and lessons learned, contributing to a broader, statewide effort to address health disparities.

Community Partnerships

At the heart of WellCare's health equity initiatives are its deep-rooted partnerships with community-based organizations. By working closely with these local partners, WellCare is able to better understand the unique needs and challenges faced by the communities it serves, and develop tailored solutions to address them.

• Community Needs Assessments: Conducting comprehensive assessments to identify the social determinants of health that most significantly impact the well-being of local communities, such as access to affordable housing, transportation, and healthy food.
• Targeted Interventions: Designing and implementing community-based programs and initiatives that address the specific needs identified through the assessment process, such as chronic disease management, mental health support, and social services referrals.
• Capacity Building: Providing training, resources, and funding to strengthen the infrastructure and capabilities of community-based organizations, empowering them to deliver more effective, culturally-responsive services to their constituents.
• Advocacy and Awareness: Leveraging its platform to amplify the voices of community partners, advocating for policy changes and raising public awareness about the social determinants of health and their impact on underserved populations.

Measuring Success: Tracking Progress and Driving Continuous Improvement

Achieving the NCQA Health Equity Accreditation is a significant milestone, but for WellCare of North Carolina, it is just the beginning of a long-term, data-driven effort to drive meaningful and sustainable change. The organization has implemented a robust system for monitoring and evaluating the impact of its health equity initiatives, using a combination of quantitative and qualitative metrics to track progress and identify areas for improvement.

Key Performance Indicators

WellCare's health equity dashboard includes a comprehensive set of key performance indicators (KPIs) that measure the organization's progress across various domains, including:

• Access to Care: Tracking metrics such as appointment wait times, transportation utilization, and telehealth adoption to ensure that members have timely and convenient access to the care they need.
• Quality of Care: Monitoring clinical outcomes, patient satisfaction scores, and adherence to evidence-based care guidelines to ensure that members receive high-quality, culturally-responsive services.
• Health Equity: Analyzing data on health disparities, including differences in chronic disease prevalence, preventive care utilization, and health outcomes across various demographic and socioeconomic groups.
• Community Impact: Evaluating the reach and effectiveness of community-based programs and partnerships, as well as the organization's contribution to broader, systemic change efforts.

Continuous Improvement

WellCare's commitment to health equity is not a one-time achievement, but an ongoing journey of continuous learning and improvement. The organization has established a robust process for regularly reviewing its health equity KPIs, identifying areas of success and opportunity, and implementing data-driven strategies to enhance its efforts.

This includes:

• Quarterly Reviews: Conducting quarterly reviews of the health equity dashboard, with cross-functional teams analyzing the data, discussing challenges, and developing action plans to address identified gaps.
• Stakeholder Engagement: Regularly engaging with members, community partners, and other stakeholders to gather feedback, understand their evolving needs, and incorporate their insights into the organization's health equity initiatives.
• Pilot Programs and Innovations: Implementing small-scale pilot programs to test new approaches and interventions, quickly evaluating their impact, and scaling successful initiatives across the organization.
• Knowledge Sharing: Actively participating in industry forums, conferences, and collaborative learning opportunities to share best practices, learn from peers, and contribute to the broader advancement of health equity in the healthcare sector.

The Road Ahead: Sustaining Progress and Driving Systemic Change

WellCare of North Carolina's achievement of the NCQA Health Equity Accreditation is a testament to the organization's unwavering commitment to delivering equitable, high-quality healthcare to its diverse member population. However, the work is far from over. As the organization looks to the future, it remains steadfast in its pursuit of sustainable, systemic change that will positively impact the health and well-being of communities across North Carolina.

By continuing to strengthen its internal culture of equity and inclusion, forging deeper partnerships with employers, regulators, and community organizations, and rigorously measuring and improving its health equity initiatives, WellCare is poised to lead the way in advancing health equity and serving as a model for other healthcare providers to follow.

As Taylor Zublena, Senior Manager of Health Equity at WellCare of North Carolina, eloquently stated, "Our partnership with stakeholders across the health care industry, including employers, regulators and community-based organizations, has been crucial in advancing health equity and improving health care for all. At WellCare, we are dedicated to cultivating an internal culture that supports our external efforts to reduce inequities in health and wellness and improve quality of care for our diverse member population through culturally and linguistically appropriate services."

Through this unwavering commitment and collaborative approach, WellCare of North Carolina is not only transforming the lives of its members, but also paving the way for a more equitable, inclusive, and healthier future for all.