Leaders and their businesses will be hearing more and more about “Population Health” in the immediate future as it applies to the health of the public as a whole and as a brand strategy to solve for inequities in the workplace and marketplace. In fact, there are Population Health executives at Fortune 500 companies who are responsible for managing the healthcare, wellness, work-life balance and other related needs of their employees and addressing similar needs in their businesses’ consumer base. Simply put, companies are learning that well-being (healthy minds, bodies, and careers) amongst employees and customers is essential to sustained success in all part of their business – especially when it comes to multicultural engagement and career advancement.
Right now, of course, “Population Health” (defined by Improving Population Health as “the health outcomes of a group of individuals, including the distribution of such outcomes within the group”) is a more common term amongst businesses that are directly connected to healthcare. But those businesses’ efforts not only show the potential benefits of this approach and the opportunities it presents but also reveal disconnects that prevent Population Health from realizing its potential as a brand strategy: It lacks a cohesive approach to leverage the collective strengths and resources of external partners. In addition, they often fail to deliver culturally sensitive solutions that can measure behavior changes in the two most pressing areas:
This is how a focus on Population Health will support the right business models to best serve the populations of what I have coined the cultural demographic shift, which will represent the new mainstream in America by 2050. Support of them will make us all better equipped and prepared to serve healthcare patients the world over (whether they are our customers, employees or families) and make organizations smarter and more operationally and cost efficient about healthcare delivery – providing better outcomes and saving more lives in the process.
Why? Because it will address a key change that the shift has brought to 21st-century business as a whole: it less about the business defining the individual and much more about the individual defining the business.
You can see this transition happening already in the healthcare industry, where the traditional physician-led business model is giving way to a new patient-centric one. Nowhere is this more prevalent than retail healthcare.
For example, since 2006, CVS Health has held “Project Health” events at its pharmacies, which offer free screenings and health services to underserved communities and uninsured in cities across the U.S. These events bring access to healthcare directly into multicultural communities – primarily Hispanic and African-American populations which carry the heaviest burden of healthcare disparities and the biggest risk of chronic disease going unchecked. The events help people to know their numbers and how to take preventative action if necessary; they also provide information about the Affordable Care Act and insurance options. Since its inception, Project Health has delivered more than $75 million worth of free health care services to nearly 760,000 people, increasing access while decreasing the cost barrier to important preventive services and screenings in multicultural markets.
Walgreens offers “Take Care Health,” evidence-based care programs from wellness to disease management for the overall health, preventive care, risk reduction and positive behavior change of its employees. According to Jim Graham, Senior Manager of Media Relations, “For populations that have been traditionally underserved, we have even greater proximity. More than 75% of African Americans and Latinos lives within 3 miles of a Walgreens store. More than half of our stores serve medically underserved areas of the United States. As a result of our geographic reach, we often become the healthcare provider of first choice when a resident of an underserved community is in need.”
Walgreens is also at the forefront of providing more care options for the people near their stores, such as adding more than 400 Healthcare Clinics in its stores, staffed by nurse practitioners and offering a wide range of services, and expanding the role of pharmacists, such as flu shots and other vaccinations given by pharmacists, something unavailable just a few years ago. This, Graham says “is part of a significant initiative to make our pharmacists more accessible as trusted health advisors, both geographically and in the patient experience.”
In 2015, Walmart launched extended-care centers: independent walk-in clinics at selected stores offering affordable healthcare services and treatment to both customers and employees. Services range from wellness and preventive care to primary acute care and management of chronic diseases. They also provide lab tests, immunizations, and referrals to specialists. For its role in improving access to healthcare and making it less costly for people to seek treatment and preventive care, Walmart was named Pharmacy Innovator of the Year 2015 by Chain Drug Review.
And at Target, the focus of Population Health is on helping employees become healthier so that they can be more effective in their work, at home, and as stronger contributors to society at large. According to Cara McNulty, Head of Population Health, the question to solve for is, “Do you create the environment for positive behavior to become the norm? We are making advances to create a culture for health and well being. Whether it’s offering an additional 20% employee discount for fruits and vegetables and other healthy food choices, or giving out Fitbits to 335,000 employees to help them overcome barriers to exercise and make healthier living more fun, our goal is to improve the overall culture, where health becomes the environmental norm – and a competitive advantage.”
Even non-healthcare industry players are getting in the game. For example, driven by its users, Facebook is moving into the public health arena. According to Wired, “Everyone on Facebook, all one-billion-plus people, will have an illness at some point in their lives. And that mass of people will share their experience battling disease, ask questions of their friends, and field advice from outsiders. Healthcare professionals can deliver information 24-7 about flu vaccines, the path of epidemics, and essential preventive care. The social network can influence how and when people respond to disease, and how we manage death and dying.”
On the medical institution front, connect the dots and you will find that Population Health goals are most often served through what are known as “community benefit” activities. The Public Health Institute, an organization dedicated to promoting health, well being and quality of life for people around the world, emphasizes five core principles for a community benefit implementation strategy: take care of the most vulnerable populations with unmet health needs; health education and protection; building a seamless continuum of care that provides a safety net of sorts for people; building community capacity with shared responsibility and sustainable efforts; and collaborative governance that gives the community a voice and oversight.
Community benefit is critical to the social advancement of multicultural patient populations, according to Nancy Clifton-Hawkins, Manager of Community Benefits at City of Hope: “Through the provisions of the Affordable Care Act, a non-profit hospital’s community benefit obligation is an important tool that can help to address the needs of vulnerable patient populations. Nonprofit hospitals are a neutral player in addressing the root causes of health disparities. This neutrality allows for the development of meaningful, collaborative and sustainable relationships with other community stakeholders. Together they can build strong lasting partnerships that make significant impact on multi-ethnic communities who often do not have a voice.”
This is another reason why healthcare must be at the core of a consumer brand strategy. Medical institutions have not historically been patient (consumer) focused and thus lack this competency. They have the money but not the subject matter expertise. Given the sense of urgency in U.S. healthcare to authentically serve multicultural patient populations, this represents a tremendous opportunity for consumer brands to partner with medical institutions and retail-healthcare stores/clinics via cooperative marketing, community-outreach and other consumer-centric strategies.
This approach can multiply the overall impact when trying to change behaviors and promote preventive care. It also shows the important role that brands must play to change consumer behavior with a strong and focused health and wellness narrative. This importance cannot be underestimated. to multicultural consumers; they must start helping them to get healthier so that they are able to achieve their best and contribute most effectively at their jobs, as consumers, and in society at large.
Which is why Population Health must be at the forefront of brand strategies and at the core of product value propositions for corporations that seek to engage with multicultural consumers. These strategies can help brands understand cultural nuances and motivations so that brands can play a more authentic role in guiding multicultural consumers toward health and well being.
Problem is, on the consumer side, these programs have traditionally have been implemented as one-off non-metric driven diversity outreach programs – as cost centers not profit centers – and social responsibility activities delivered through the non-profit foundation arms of Fortune 500s. For example, The Walmart Foundation finances grants to support underserved multicultural communities where their stores do business.
The Population Health role is unique in that it seeks to engage with ethnic communities as not only consumer segments – but as “population” segments whose advancement in society is essential to the economic prosperity of the country as a healthier whole.
As Population Health takes off at more and more Fortune 500s and medical institutions, pharmaceutical companies, retail-healthcare and consumer brands step up to help manage the overall health and wellness of their employees and consumers, an immense amount of work will be required to stitch the disconnected parts together and streamline the process. This is much more than the subject matter expertise of any one business or organization can handle.
Given the magnitude and multiple variables involved to solve for health inequities, external partnerships are critical, says Randy Martinez, Director, Strategic Diversity Management, Pharmacy Benefits Management at CVS Health: “The many multicultural community partners we engage with help us define our message and tailor it to the communities where we operate as a retailer. From an overall healthcare perspective, external partnerships are a lifeline to our customers and patients. Our partners not only help us convey the message that puts people on the path to better health, but they help fit the message to the diverse communities we serve.
“We are not looking to simply write a sponsorship check to our external partners and show up to events. When we engage we look for ROI – which means looking at how an organization aligns with our purpose, our vision and our core values. We have a very stringent identification process to ensure that an alignment exists and then we have a comprehensive backend assessment to ensure that the partnership delivered. If it didn’t, we may explore other programs that we can engage in with them, such as training, co-branding, education, recruiting, and other culturally relevant programs.”
At the center of all these discussions at CVS and beyond is the rapid growth of the U.S. Hispanic population, which is leading the charge for changing the business of health and business as a whole. You can see this most clearly in the urgent need for more culturally competent physician care and genetic research to serve those Hispanic populations and amongst Hispanics themselves in the call-to-action to become more educated about preventive care and self-advocacy.
Yet most in the healthcare industry are lagging behind this key part of the cultural demographic shift says Dr. Ricardo Martinez, Chief Medical Officer at North Highland, “When you reframe the conversation about public health and healthcare disparities in terms of population health, it becomes a different dialog – one about opportunities.” Adds Fletcher Lance, Global Healthcare Lead & Managing Director at North Highland, “There’s an emerging America – a new America – coming to the forefront, and it’s surprising how many people don’t see it.”
And if you don’t see it, you can’t seize the opportunity.
For Hispanics, according to Lance, that opportunity represents a 43% growth rate, versus 14% for the general population. And the Hispanic population not only skews younger but also tends to have longevity, so that means more opportunity and value over a lifetime.
According to Dr. Martinez, “We’re at a tipping point. Every other industry has started to embrace the Hispanic consumer as an opportunity for growth. By comparison, healthcare has been inert. Our ‘Executive Healthcare Survey on Hispanic Health’ shows that 44% of healthcare institutions have not looked at their demographic makeup or the changes taking place within it. And 60% have not evaluated the financial opportunity that Hispanics represent in healthcare. Yet 74% said that they are adequately meeting the healthcare needs of Hispanics.”
“That’s a huge disconnect that needs to be corrected,” explains Fletcher Lance. “We need to be more proactive in addressing this gap. If you don’t start focusing on your changing demographics, you’re going to fall further and further behind in cultural competency – the very thing you need to form long-term community relationships with these emerging populations.”
To form these relationships and achieve Population health, what happens outside the hospital or doctor’s office walls are increasingly important. This means reaching out into communities, connecting with them, and breaking down barriers – whether they are ones of awareness or access, communication or cultural know-how. This is another reason consumer brands must play a more strategic role in activating healthcare solutions amongst urban and multicultural communities that are changing the business of healthcare. This should be a natural outgrowth of the shift in the healthcare industry to be more patient-centric.
But that doesn’t mean it’s going to be easy to attain. A more focused, holistic approach is required among stakeholders committed to solving for the health, wellness and societal advancement of multicultural communities. Proactively tending to the needs of multicultural patients and their families demands a highly strategic and collaborative effort between these communities and those that serve them. From medical institutions, retail-healthcare and pharmaceutical companies, financial and insurance service providers to STEM educators, government leaders and consumer brands – all must be actively involved in the conversation to influence the business of healthcare, both directly and indirectly.
Historically, this collaboration and focus on the needs of the individuals is exactly what the business templates of the past prevent us from achieving: the focus on the needs of the business, not the individuals. This is where the real opportunity lies: where saving lives and generating ROI co-exist.
The unique healthcare needs and lifestyle perspectives of multicultural patients have rarely been understood or valued enough – or they would be reflected in organizational missions, business models, and customer value propositions. As a result, the gap is widening between those gaining health insurance and access to healthcare and the lack of physicians culturally equipped to serve them.
Consider the way America is failing to invest in and solve for the growing opportunity gaps that are preventing Hispanics and African Americans from pursuing careers in the healthcare and biomedical fields, despite the urgent need to build a more diverse talent pipeline in the healthcare industry. The gap extends beyond physicians to the healthcare workforce across all functional roles and responsibilities.
Consider how retail healthcare continues to play a more defining role in the delivery of healthcare services in the U.S, their responsibility to help solve for the widening talent gap in the healthcare and biomedical fields amongst minorities, especially Hispanics, will heighten. Those businesses must join leaders from medical institutions who predominantly serve Hispanics – as well as other multicultural communities – where there is a need to attract, develop and advance Hispanic talent in order to more effectively serve the unique needs of the growing Hispanic patient population.
Each stakeholder must establish clarity and understanding about what the cultural shift means for their organization. But given the urgency, they must also come together to heighten awareness across industries and across the country, which will fuel diversity of thought, help solve for the talent gap faster, and bring attention to other opportunity gaps in the delivery of health and wellness to multicultural communities.
By sharing experiences and proven best practices, we can accomplish all of the following and more:
In the end, just like the cultural demographic shift as a whole, no one organization has a real solution for Population Health. Only together can we address the urgent need to more authentically serve and build loyalty/trust with multicultural communities. Only collectively can we promote proven preventive care methods and the need to close the healthcare workforce development gap in culturally fluent ways. Only when this cultural fluency is achieved with brand strategies and partnerships that authentically lead, innovate and engage with today’s increasingly multicultural workforce, patients and consumers will we have the ecosystems that truly make it about the individual defining the business.
It is only through courageous approaches that real solutions will prosper and multicultural patient populations will influence the evolution of the healthcare industry.