Engaging members and patients, employees, and communities beyond health

The root causes of disparate health outcomes include racism and bias, structural flaws in the health care system, and deep inequities within the drivers of health (DOH). To advance health equity, organizations should look outside of the traditional health care system and address these social, economic, and environmental factors that lead to healthy or unhealthy outcomes. This research focuses on the ways health care leaders can address inequities in the DOH in their patients and members, employees, and community, and through relationships in the larger ecosystem. In 2017, the Deloitte Center for Health Solutions surveyed nearly 300 health system leaders and found that 80% said they were committed to establishing and developing processes to systematically address social needs as part of clinical care. However, the same survey revealed that much of the activity was ad hoc, and gaps remained in connecting initiatives that improve health outcomes or reduce costs. This time, as we relaunched the survey with health system leaders, we added health plan leaders.

The 2021 Drivers of Health Survey of 49 health plan leaders and 251 health system leaders revealed the following insights into areas in which health care organization leaders can impact DOH to achieve greater health equity:

As we saw in the prior survey, in nearly every DOH area, health care leaders say they are screening their patient and member populations for need. However, far fewer say they are acting on those identified needs by, for instance, establishing in-house programs or creating formal partnerships with community-based organizations (CBOs). For example, while 80% say they are screening their patients and members to determine whether they might need access to food banks or vouchers, only 35% have established community partnerships to address identified needs in that area.

While 69% of health plan leaders and 63% of health system leaders say they have general partnerships with local community- and/or faith-based organizations to help address DOH, fewer than one-third of overall respondents say that they are leveraging community partnerships to address specific DOH needs in their patients and members or larger community.

Fewer than half of health system leaders (49%) and health plan leaders (45%) say they have partnered with other health care organizations to address DOH needs. Just over half of health plan leaders (55%) and 44% of health system leaders say they partner with technology vendors that provide solutions like ride-sharing or digital financial literacy vendors.

Fewer than half of health care organizations are screening or providing programs to their employee populations around economic or environmental DOH (e.g., 41% are screening their employees to identify whether they are able to pay their bills or whether they have stable housing versus 78% who say they are screening their patients). Education is the only DOH area where employees receive more attention than patients and members and the larger community.

In 2017, 20% of health system leaders said that value-based models or initiatives that emphasize the integration of DOH into health care would lead them to increase their organization’s investments in this area. By 2021, this increased to 58% of health system leaders.

Most of the survey respondents agree that improving health outcomes is a top goal underlying their DOH strategy (90% of health plan leaders, 74% of health system leaders).

Health care organizations and their leaders looking to impact their patients and members, community, and employee populations’ DOH should implement well-defined DOH strategies now. Leaders should consider:

• Creating accountability and governance for DOH initiatives
• Measuring and evaluating programs and initiatives
• Embedding DOH approaches into clinical care
• Ensuring their own employees’ needs are being addressed
• Strengthening relationships with CBOs
• Looking to new ecosystem partners