During her tenure at PreferredOne, Dr. Abbie Miller, the health plan’s Chief Medical Officer, has placed an acute focus on health equity. As a physician, she knows firsthand how critical it is to address health disparities in a meaningful way to improve patient outcomes. Asking the community for their preferences is a vital step. The Council recently caught up with Abbie to get her perspective on PreferredOne’s health equity journey.
QUESTION: How long have you been with your organization and what’s been your journey to your role?
ANSWER: I have been with PreferredOne for 2 years as the Chief Medical Officer (CMO). I am board certified in family medicine and I spent my career prior to PreferredOne in care delivery working as a hospitalist as well as medical director of care management and utilization management for a large system. In my role as a practicing physician, I came to the realization that there are problems inherent in the health care “system” that result in poor outcomes and health inequities that cannot be addressed simply through improving the doctor/patient relationship. This drove me to take on an administrative role so that I could help bring the lens of the provider to those larger “system” conversations.
Q: Disparities in health care have always existed, but in your view, how have recent events – like the COVID-19 pandemic and the murder of George Floyd – impacted health equity work and where it is headed?
A: I think that recent events have brought a new level of awareness and brought the conversation to the forefront. In health care, we have spent time examining the problem of health equity, often discussing “social determinants of health.” We recognize that health outcomes are different based on these factors, but my hope is this momentum will drive us to action rather than continued examination.
Q: What are some of the biggest barriers you see in delivering equitable care and what are steps that health plans can take to better connect with BIPOC communities?
A: I continue to see gaps in ensuring patients feel they can relate to their provider. This means we need more diversity in our provider networks, which starts with ensuring more diversity in our medical education programs. I think the best way to connect is to not presume we know what is desired or needed and instead have conversations with those in our community about their experiences and ask for input.
Q: What specific initiatives (committees, taskforces, work groups, cabinets, etc.) have been created at your organization to address health equity? And given these initiatives, what progress has been made in terms of making care more equitable?
A: At the health plan level, we are trying to gather more information about the providers and members covered by our plan. We want to know whether they are more comfortable speaking a language other than English, whether they are a person of color, whether they identify as LGBTQ. Then we want to make sure that our provider network is similarly diverse and that we not only identify a provider’s specialty but also what language(s) they speak and whether they are experienced in caring for LGBTQ persons. We are making slow progress on this given we have to overcome perception of the historical use of this information to discriminate.
As a system-owned health plan, our system owners have created the H.O.P.E Commission to better identify systemic issues that lead to disparities and create a plan to address those issues.
Q: What role do you see partnerships (with the community, with the state, with others in the health care ecosystem, etc.) playing in advancing health equity efforts?
A: I believe partnerships are crucial in this work as it will take a system-based approach to fix systemic problems. We must work together with community organizations to have hard conversations about shared past negative experiences, reach a common understanding about future needs and work together to create trust and a path forward.
Q: What role does organizational culture and diverse staffing play in health equity? How can health plans use cultural competencies to improve health outcomes?
A: As I stated above, we relate to one another through shared experience and shared history. Ensuring diversity throughout our health plan staff, just like our network, will help our diverse members feel more comfortable. It will also raise collective awareness and cultural intelligence across the organization.
Q: Distrust in the health care system continues to be a huge challenge when it comes to health equity, which has been laid bare by lower COVID vaccination rates in communities of color, but impacts other care, also. How do we rebuild trust in BIPOC communities?
A: We must work together with community organizations to have hard conversations about shared past negative experiences, reach a common understanding about future needs and work together to create trust and a path forward.