September 24, 2024
Health equity means achieving fair access to health care for everyone. While that may sound like a simple goal to reach, it’s not when you consider common social factors, such as nutrition, housing, education, pollution and discrimination. Research shows that these factors—social determinants of health—influence up to 80% of health outcomes.¹ Poor nutrition, housing instability, low education, pollution and discrimination all contribute to poor health. All are indicators of populations whose health has historically been underserved.
That’s why advancing health equity requires offsetting the long-standing social factors that interfere with good health. It takes breaking down barriers so that all members can get information about and access to care that helps them live their healthiest possible lives. And it requires developing a deeper understanding of our members’ lives through data.
We will collect more member demographic data beginning with open enrollment for 2025. New and renewing groups that enroll online will see a newly expanded list of member demographic data points for enrollees to complete. These include race, ethnicity and language. These data points are optional, but we’ll ask employers to encourage employees to provide them.
While new groups will see the new member data options when using 834 enrollment files, we’ll begin collecting this data for existing groups using 834 files upon renewal.
We began allowing members in new and renewing groups using paper and spreadsheet enrollment forms to self-report this data last year. In addition, we’ve been collecting data on members of fully insured groups of 51+ who identify as gender nonbinary since 2022; this data can affect access to our gender-specific clinical programs, such as reminders for breast or cervical cancer screenings.
We’re not required by any mandate to do this work, but collecting this data for more members will help us better assess disparities in how they’re able to access care. In addition, it will enable us to enhance our clinical programming and support providers in addressing members’ health through physical and behavioral measures and through a social and cultural lens.
Maternal health is one example of how member demographic data helps us better support underserved members. Through data insights, we’re enhancing our pregnancy program to provide more equity-centered support for members in certain high-risk groups. This includes Care Management outreach and support, educational materials about high risk and guidance to more postpartum doctor visits. Another example is serving our members in the LGBTQIA+ community with comprehensive gender-affirming care and a Customer Service team specially trained to support the unique needs of LGBTQIA+ members.
Achieving health equity is a long-term journey, and collecting more member demographic information is one piece of a much larger effort.
For questions about 2025 enrollment forms, please contact your account representative.
- Source: Hood, C. M., K. P. Gennuso, G. R. Swain, and B. B. Catlin. 2016. County health rankings: Relationships between determinant factors and health outcomes. American Journal of Preventive Medicine 50(2):129-135. https://doi.org/10.1016/j.amepre.2015.08.024