Disparities among demographic groups related to access to care, as well as the quality of that care, have been widespread for decades across the health care system, and hospice is no exception. To help their organization address this issue, Clearwater, Fla.-based hospice, palliative care and home health care provider Empath Health has appointed Karen Davis-Pritchett to be the organization’s first Vice President of Access and Inclusion, effective Oct. 1.
Nearly 87% of Medicare decedents in 2016 were Caucasian, according to the National Hospice & Palliative Care Organization (NHPCO). Comparatively, slightly more than 8% were African-American; 2.1% were Hispanic, and 1.2% were Asian. That year, only 0.2% of Medicare decedents were Native American.
In addition to race and ethnicity, disparities also exist across religious lines and among the LBGTQ community
In addition to lower rates of overall utilization, hospice patients who are members of minority communities are more likely to leave hospice, be admitted to the hospital, or visit the emergency department, research has found.
Addressing these disparities is not only a moral imperative; it also makes solid business sense. Closing the gap on demographic disparities in hospice care alone could save Medicare as much as $270 million annually, according to a study published earlier this year.
Minorities have seen the largest percentage gains in purchasing power since 2000, according to the Selig Center for Economic Growth at the University of Georgia. The combined buying power of African Americans, Asian Americans and Native Americans reached an estimated $2.4 trillion in 2018, while spending power among Hispanics in the United States hit $1.5 trillion.
Prior to becoming vice president of access and inclusion, Davis-Pritchett since 2016 had served as Empath Health’s director of professional and community outreach, she was already working to improve admissions among African American, Hispanic and Jewish patients.
Davis-Pritchett recently spoke with Hospice News about how she will lead Empath Health’s work with underserved communities.
What will your role be as vice president of access and inclusion?
My role will be ensuring that all communities within our service area have access to our services, creating our outreach plan, and that looks at how do we engage our diverse communities that we have represented here in Pinellas County [Florida].
I will also be helping our outreach team and liaisons to work with our care partners in the community to help address how those communities interact with those partners as well.
My understanding is that this is a newly created position. What factors made it necessary to have a corporate officer who is performing this role?
It goes back to Empath Health’s commitment to equity in various areas of health care and understanding that we need to be very intentional with our outreach to diverse communities. We live in a very diverse world now, and ensuring that all communities and all groups have access to quality care and provide a culture here within our organization that supports that goal, so that we are not only honoring diversity but also being inclusive.
Inclusivity is important, honoring people’s voice and honoring people’s experiences and cultivating that kind of culture here in our organization.
Which populations are most underserved as far as hospice is concerned?
Historically there are four that we are concentrating on right now: our African American population, Latin-x, our Jewish populations as well as our veterans.
What are some of the factors that contribute to those disparities?
What we have seen is a lack of education and understanding about what hospice care entails, and a degree of fear of having someone take over the care of their loved one. Those are barriers. And just historically members of these groups may have experiences with other care providers that may not have been culturally competent or welcoming to them.
So part of our role is, No. 1, being present in those communities and listening to what their concerns are and then customizing our outreach to meet those concerns.
Will there be any internal staff training in terms of cultural competency?
Yes. We currently are also completing our SAGECare Platinum Certification for working with our LBGTQ elders and understanding their barriers to care and their concerns regarding their care, and making sure that we are effectively taking care of them when they come onto our services.
Also, we are providing education to foster the understanding that our organization is a place where we value everyone, that we value difference and seek ways to make those differences into strengths to ensure that we are meeting the mission and vision of our company.
In regards to the SAGECare certification, do LBGTQ patients have unique clinical needs in comparison to other patients in the general population?
I don’t know necessarily if there is a unique need in regards to care, but there definitely needs to be an awareness of what this population has experienced that may make them afraid of the health care system. Part of that is making sure that their partner or their spouse has access to understanding of what their treatments are and their plan of care, and helping them feel safe that we are going to provide care and be nonjudgmental. That is what we are striving for.
Across all of the populations we serve, when you think about our diverse communities, it’s about meeting them where they are and helping build trust and cultivating relationships within those communities so that they do see us as an ally.
What are your top priorities as you come into this position? What will you be doing first?
I think first it’s continuing education with our senior leaders. This is something that we have been doing during the last two ears, continuing to build their cultural competency.
That’s what we are going to be focused on first, as well as developing a diversity plan to define how we are going to conduct our outreach and continue to engage with our diverse communities, increasing our robust outreach and using those strategies to ensure access for those communities.
What are some of the strategies that are you using to reach out to underserved populations?
One of the most important things is to identify where there are community groups or civil organizations that can be naturals partner that we can collaborate with, whether that is hosting a presentation, or otherwise establishing that relationship with them and establishing that trust.
Many people automatically go to the faith community — which is a great resource — but there are many people who may not be formally affiliated with a particular faith. So it is also really important to find those other community spaces where we can establish a presence and build relationships. How do you collaborate together to improve access for that community?
We need to be really aware of what these patients’ needs are and not make assumptions about what the community needs. We have to listen to them and understand where the strengths are in the community. Then we need to capitalize on and leverage those strengths in order to expand access to hospice services, dispel those myths, and tear down those barriers that are hampering access.
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