During his time at Hennepin Health, Michael Webber, the health plan’s Analytics and Health Economics Manager, has taken health equity initiatives head on. His work entails working directly with vulnerable communities to find solutions that will enable better health care. This involves intentional listening, learning — and doing. The Council recently caught up with Micheal to get this insights on Hennepin Health’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 worked for Hennepin Health for 3 years in analytics and health economics. I previously worked in accountable care organization (ACO) analytics at Fairview and in orthopedic bundled payments and lean at Avera Health in South Dakota. I came to Hennepin Health because I was excited to apply my skills at the intersection of finance, operations, and analytics at an organization with a mission to improve health care for members that often face social and behavioral health barriers. I believe analytics has a role to play in highlighting disparities and the measuring the efforts to improve them.
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’m proud that Hennepin County and Hennepin Health were already prioritizing equity before the pandemic and the murder of George Floyd. These events brought attention to areas where we were already making investments.
Hennepin Health provided funding in 2019 for a Hennepin Healthcare project that improves prenatal care for American Indian and Black/African American communities through models of care that incorporate community-based and culturally responsive programming. The same year we provided funding for a pilot program at Northpoint called the Mama Mtoto program for Black/African-American mothers facing social barriers. We also have invested in recruiting and training doulas from groups that experience health disparities.
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: In analytics, we are specifically focused on measuring disparities. We need to be able to measure disparities in order to know where to focus our efforts and to know whether or not our efforts are improving them.
At the same time, getting the perspectives of individuals in groups experiencing disparities is important. I previously mentioned a Hennepin Healthcare project that we funded. Hennepin Health conducted a series of ten listening sessions with 168 U.S. born Black/African-American and American Indian women that focused on the women’s current experiences with prenatal care, birth, and postpartum care as well as their suggestions for what would improve those experiences and increase engagement with care. Their input was invaluable in improving prenatal models of care for Black/African-American and American Indian women.
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: Hennepin Health funded the Mama Mtoto pilot program at NorthPoint. Black/African-American women experience an infant mortality rate of 10.4 per 1,000 births compared to 5.1 per 1,000 births across all other racial groups in Minnesota. The program uses a psychotherapy support group structure to teach positive coping behaviors, self-regulation, and child management skills. The program simultaneously encourages prenatal and postnatal visits. Of the 43 women enrolled, 85% had prenatal care within the 1st trimester, 82% completed an obstetrics physical at time of enrollment, 100% had at least 6-8 prenatal appointments with their primary care provider, 100% have completed a postpartum visit, 100% had healthy birth outcomes, and 100% of the babies delivered have completed well-baby exams.
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: Providers tend to have more direct relationships with our members so we tend to partner with our providers. We know to make a difference that we need to support and leverage patient relationships with providers. We can do more with our partners than we could ever accomplish otherwise.
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: Listening session participants from the Hennepin Healthcare project frequently mentioned the desire for doulas from the same cultural background as themselves. In response we provided funding for a program through the Cultural Wellness Center to recruit and train U.S. born Black/African American doulas. The goal is to establish a perinatal workforce across Hennepin Health’s provider network that reflects the diversity of the plan’s enrollees. The program trained 15 Black/African American doulas who are now registered with the state to provide doula care.
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: I believe listening is the key. I’m proud that a Hennepin Health-funded program led to listening sessions that solicited feedback from 168 people from BIPOC communities. We can point to specific funding for culturally-specific doulas that arose from that effort. BIPOC communities are going to trust us more over time if we solicit their perspectives and implement concrete responses to what we hear. In the end, we believe people support what they help create.