The Cost of Health Disparities

00:00:00:02 - 00:00:18:19
Tom Haederle
Welcome to Advancing Health. Differences in health outcomes affect patients and communities, but also contribute to lost workforce productivity and hundreds of billions of dollars in avoidable health care spending. More health care leaders are recognizing these challenges and taking action.

00:00:18:21 - 00:00:48:25
Joy Rhoden
This is Joy Rhoden, senior vice president for the Division of Health Outcomes and Care Transformation at the American Hospital Association. And today, we're going to be talking about the economic impact of disparities in health outcomes. Health disparities have long been recognized for their impact on patient outcomes, but we know that they also carry significant macroeconomic and microeconomic impacts and consequences.

00:00:48:27 - 00:01:25:10
Joy Rhoden
At the macro level, I'd like to share just a few findings from our research as we developed this guide for the field. The data from 2022 show that national analyzes estimate that disparities in health outcomes are associated with approximately $320 billion dollars - with a B - in excess health care spending each year, with projections indicating that this figure could actually rise to $1 trillion dollars by 2040 if disparities remain unaddressed.

00:01:25:12 - 00:02:03:09
Joy Rhoden
I don't think this is a problem we can ignore. So our members often ask why, in a resource constrained environment, should they pay attention to and invest in strategies that will reduce health disparities? And today I am joined by Brian Peters, chief executive officer of the Michigan Health and Hospital Association. Brian and I will discuss how health disparities not only impact health outcomes at the individual level, they drive avoidable costs across health care systems.

00:02:03:09 - 00:02:29:08
Joy Rhoden
They reduce workforce productivity and lead to excess health care spending and expenditures for individuals, families and society writ large. Brian, thank you for joining me today. And I'd like to invite you to introduce yourself a little bit better than I did and share just a bit about the work you're leading in Michigan.

00:02:29:10 - 00:02:54:04
Brian Peters
Well, thank you, Joy, it's a pleasure to join you today and talk about this very important subject. The Michigan Health and Hospital Association has been around for a while. We just celebrated our 100 year anniversary a few years ago, and we've been a very strong advocate for literally every hospital and health system in the state of Michigan. They are all engaged members in good standing of our association.

00:02:54:04 - 00:03:22:20
Brian Peters
And we partner with the American Hospital Association, both on the advocacy up front, but also on a number of other issues outside of the public policy arena as well. And our mission is very straightforward. We advance the health of individuals and communities, and that's a mission that's very consistent, almost identical with the American Hospital Association. And I think that's given us a really excellent platform to collaborate on this work.

00:03:22:21 - 00:03:42:26
Brian Peters
I will tell you that it has been a great privilege for me to serve at the MHA for now 37 years, the last 11 as CEO, and to serve on the American Hospital Association board as well, with some really remarkable leaders. And I'm just so proud of the work that we're able to do together.

00:03:43:03 - 00:04:12:06
Joy Rhoden
Well, thank you so much for your strong leadership and certainly for the tight coordination that we enjoy with you and your other state hospital association peers, you know, really leading the charge to improve the conditions so that our hospitals can continue doing the good work that they do for the communities they serve. So to get us started, we often think about health disparities in terms of patient level outcomes.

00:04:12:06 - 00:04:38:14
Joy Rhoden
And we talk a lot about the moral imperative to act. I think an underexplored area, Brian, is the economic impact of those same disparities. And so I wonder if you could shed some light on why you think health care leaders should pay attention to the financial considerations that can sometimes be overlooked?

00:04:38:16 - 00:05:00:18
Brian Peters
Well, there's no question this should be a main focus. And, you know, I'm someone that always looks at the optimistic view anytime we're dealing with major challenges. And so as you know, Joy, both for the American Hospital Association, for the Michigan Health and Hospital Association, and frankly, for our colleagues all over the country. What is the hot topic, if you will,

00:05:00:19 - 00:05:27:06
Brian Peters
right now? It is an election year topic, and that is the topic of affordability. And I think we're all wringing our hands about this issue. And, you know, we've been called to task. Why are health care costs so high? I think we've been given a gift, quite honestly. This is my optimistic view because this new conversation on affordability, it's shining a very bright light on the underlying factors.

00:05:27:06 - 00:05:54:14
Brian Peters
And what I'm getting at here is when we talk about disparities and as you said, the economic impact of disparities. Now we have the full attention of everybody from, you know, our own membership to elected officials, the media and the business community to talk about the role that economic impact plays when it comes to these issues of disparities.

00:05:54:14 - 00:06:13:08
Brian Peters
We can make that very close connection. And so this is an opportunity that we don't want to squander. And I'm very pleased to see the American Hospital Association wading in in a very significant way. And with this new report, I think it's going to really help our efforts in a significant way.

00:06:13:15 - 00:06:43:22
Joy Rhoden
Thanks. Thanks for that, Ryan. I think to your point, we're bringing everyone in under the tent, now, when you start to talk about the finances as well. But let's remember that the backdrop for much of this conversation around affordability, as you just called out, is a resource constrained environment, right? So hospitals are facing increasing pressure to improve their outcomes and manage costs.

00:06:43:25 - 00:07:21:24
Joy Rhoden
And as I pointed out earlier, you know, it's growing exponentially at the macro level to it's at a pace that's just not sustainable. Healthcare is inching close to 20% of GDP. So something's got to give. What do you say - and you started to talk about some of the root causes - what's behind the affordability challenge. What are some of the benefits that accrue when hospitals and health system leaders start to really pay attention to variation in care and variation in health outcomes, and work to close those gaps?

00:07:22:01 - 00:07:48:27
Brian Peters
Right. You know, we've said for many years that high quality health care costs less in the long run. So that, for example, anytime you avoid a medication error or a wrong side surgery, or you avoid a readmission because you've done a really good job managing that post discharge process, you're going to ultimately create a better outcome for the patient, but you're going to save cost as well.

00:07:48:27 - 00:08:17:06
Brian Peters
And I think that the similar concept applies here. In other words, if we can do a better job of addressing health disparities and do that in a proactive way as opposed to just dealing with problems once they show up in the hospital emergency room, which is the model that unfortunately we have in many places today, I think we're going to clearly create better outcomes for patients, but we're also going to help to bend the cost curve as well.

00:08:17:06 - 00:08:46:14
Brian Peters
This is the ultimate win-win, and I think that's a message that we have to convey effectively and consistently to all of the audiences who are part of this conversation. That's really the challenge before us. I think the AHA and the state associations, because as we know that the states are often the laboratory for reform, not only in health care, but in terms of any public policy challenge.

00:08:46:16 - 00:08:56:14
Brian Peters
And, you know, we have the resources at our disposal to make our voices heard and to tell this story. That's really what this this will entail.

00:08:56:15 - 00:09:06:21
Joy Rhoden
And I presume when you talk about a proactive approach, you're really leaning into a data informed approach, right?

00:09:06:25 - 00:09:30:28
Brian Peters
Data has to play a role. It has to play a role. We found that, by the way, through our efforts at the MHA Keystone Center for Safety and Quality. It starts with data. You have to measure outcomes. You have to measure process so that you have a baseline, so that you understand where the challenges are. And then you can track your progress and you can identify where things are working and where things aren't working.

00:09:30:28 - 00:09:58:00
Brian Peters
And so that data is critically important. You're absolutely correct. And it helps to tell a story. And I've always been one who says when you're advocating. And that could mean advocacy at the state or federal level in the political environment. But frankly, it could mean advocacy with our constituencies at the local level. You have to have data and stories, right?

00:09:58:02 - 00:10:20:29
Brian Peters
You cannot you cannot have one without the other, because data on its own can be misleading. Stories without data to support them can be misleading. So you really do need to have both. And I think we have both. I think we have to do a better job collecting meaningful data and disseminating it. But clearly those two things are important.

00:10:21:00 - 00:10:43:22
Joy Rhoden
I think you're right, Brian. I actually don't think we have a shortage of data. The challenge becomes how do you make those data actionable, right, to drive the improvements that you're after. So we spend the first half of the year developing this guide that we've been referencing on this, in this conversation, a guide on the economic impact of disparities in health outcomes.

00:10:43:22 - 00:11:15:21
Joy Rhoden
And I have to say, it's a better deliverable because of the insights we received from you and your peers on the Divisions Advisory Council. In your opinion, what are some practical ways hospital leaders can use the insights from this new resource to make the case, right, for investing in strategies and interventions, and the right dosage of those interventions that will focus on the reduction of health disparities.

00:11:15:24 - 00:11:41:24
Brian Peters
Well, in my mind, there's a two part challenge here. I think the first challenge is you have to win the home field advantage first, meaning you have to rally your own organization, the key leaders and the frontline caregivers in your own organization to let them know this is a priority for us. From this moment forward, this is now a priority with all that that entails.

00:11:41:24 - 00:12:06:21
Brian Peters
Meaning it's going to be a standing agenda item at our governing board meetings. We're going to have, to your point, actionable data that we're tracking. And we're holding supervisors and managers accountable for our progress so that you have everyone on the team pulling in the same direction. I think the resource guide that the AHA has pulled together and enjoy you in the team have done a great job in that regard.

00:12:06:22 - 00:12:30:20
Brian Peters
What I like is you spotlight some of the AHA members across the country who are doing some, some really neat things, and there will be many other similar examples where we can learn from each other. So you can you can share some of those learned experiences, but winning that home field advantage first and then from there, I think it's bringing in your key partners in the community.

00:12:30:20 - 00:12:53:03
Brian Peters
Because one thing we have learned without question in doing this work is you cannot move the needle by working in a silo. It will not happen. You know, when you're addressing disparities and all of the issues related to housing and transportation and language barriers and food insecurity and all the rest, we have to work with key partners in the community.

00:12:53:03 - 00:13:17:25
Brian Peters
And I really think about the business community as we're making this case, because you think about this fact - and you know this, Joy - so many of the people that we're talking about here that we want to serve in a better way, in a more proactive way, they could be better, more engaged and consistent participants in the workforce if they're healthy.

00:13:17:27 - 00:13:30:22
Joy Rhoden
As we wrap up, I guess I'd ask you for one key takeaway you hope our listeners will remember about the connection between health disparities and economic impact.

00:13:30:25 - 00:13:55:02
Brian Peters
Well, there's an absolutely significant and direct correlation between the two. We have to understand that and embrace it and tell that story and tell it very, very consistently. I really believe that in our very complex world of health care, we cannot move the needle on any of our challenges if we don't make it clear that this is a priority.

00:13:55:02 - 00:14:20:06
Brian Peters
And so I think what the AHA is doing in this work is stating that case for this as a priority. I think our leadership around the country has to follow suit. We have to speak with a united voice, and we have to bring in key partners who understand the only way we're going to create economic viability in our communities throughout the country,

00:14:20:06 - 00:14:42:16
Brian Peters
the only way we're going to start to bend the healthcare cost curve is to embrace this work, the work of health outcomes, particularly when it comes to underserved communities, and embracing all of these social drivers of health status. We can do better. We know we can. And I'm excited about this work that lies ahead.

00:14:42:19 - 00:15:15:01
Joy Rhoden
Super excited about the possibilities that lie ahead. To your point, Brian, for hospitals to do this work in partnership with others, I mean, at the end of the day, I can think of very many examples where the hospital actually ought not be in the driver's seat, but maybe serving more of that role as a as a convener, if you will, to bring together all of the assets that the community possesses, all of the other key stakeholders to design for the health of that community, right?

00:15:15:02 - 00:15:39:08
Joy Rhoden
And so if we multiply that across the various many communities that our members serve, we will be making a really good deposit towards a more a healthier environment for all, which is the goal, right? At the end of the day, the AHA's vision is of a just society of healthy communities where all individuals reach their highest potential for health.

00:15:39:08 - 00:16:01:22
Joy Rhoden
And so that really is our tall order. So I want to thank you for joining us and for sitting down with me today and providing your insights on this, on this topic. And I want to let the folks who are listening know that the new resource guide is available on the AHA's website, and we will also link to the guide in the podcast description.

00:16:01:22 - 00:16:05:24
Joy Rhoden
So thanks again and thanks for being with me, Brian.

00:16:05:26 - 00:16:10:08
Brian Peters
Joy, what a great pleasure. Thank you. I look forward to continuing our work together.

00:16:10:10 - 00:16:12:00
Joy Rhoden
Take care.

00:16:12:02 - 00:16:20:26
Tom Haederle
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