Humana Launches Diversity Program

The newest approach to effective health care for all seems counterintuitive: It begins with the idea that members receive the least biased care from medical providers who understand patients' racial, ethnic and cultural backgrounds.

To manage members' needs related to diversity, Humana is launching the Clinical Disparities and Cultural Diversity (CDCD) program. The CDCD program helps medical professionals understand diverse backgrounds so they can provide appropriate care. This knowledge is known as "cultural competence."

Cultural competence has a lofty goal. It aims to create a health care system capable of delivering high-quality health service to every patient regardless of race, ethnicity, culture, language or socioeconomic status.

Humana's CDCD program
Increasingly, research shows that health care outcomes depend on patients' perceptions and behaviors. Heritage can shape these traits. In addition, ethnic background can affect biological health needs.

"Disparities in health care are the result of complex issues that cannot be eliminated with a single strategy," said Debbie Pennington, R.N., clinical advisor, corporate quality management, for Humana. "Humana's CDCD program takes a multidisciplinary approach. It supports members and providers through all facets of becoming a culturally competent organization."

This approach involves the following four tactics:

• Data collection on race, ethnicity and primary languages
• Cultural competency training as a foundation to improve care
• Quality improvement activities/initiatives to address disparities
• Effective communication efforts

The four steps in action
The early stages of Humana's CDCD program are under way.

Data collection
"The first step in identifying disparities in care and moving forward with quality initiatives is to collect race, ethnicity, primary language and socioeconomic data," Pennington said. "Primary data collection, directly from the member, is the most reliable." Other sources of data collection include ZIP code and surname analysis, which infer that a member belongs to a particular race or ethnic group.

Humana encourages members to complete the race/ethnicity section of the online MyReality Check, a personalized health assessment form. Once a member signs in to his or her MyHumana account, he or she can access the form, which is located under "Health Resources." The form provides Humana with information about the member's health needs and helps the company provide specialized services to address them, including clinical and disease management programs. The completed form also provides the member with steps to improve his or her health.

In the future, Humana may request diversity information during plan enrollment, customer service calls and when members participate in programs, such as disease management, case management or Personal Nurse^®.

Humana will use collected data for the following purposes:

• To identify cultural disparities
• To identify needed resources
• To develop quality improvement initiatives

Cultural competency training
Humana is developing a cultural competency training program. Additionally, the provider area of Humana.com will include links to national Web sites, including America's Health Insurance Plans (www.ahip.org) and the Agency for Healthcare Research and Quality (www.ahrq.gov). These organizations are spearheading diversity initiatives, which Humana supports.

Quality improvement
Quality nurses visit physician offices and promote cultural competency education and awareness. Humana recommends that physicians and their staff members review the book Culture and Clinical Care (UCSF Nursing Press, 2005). This book aids clinicians in understanding ways to provide care to patients from diverse ethnic and cultural backgrounds.

"It's a set of general guidelines to alert readers to the similarities and differences among a variety of cultures," Pennington said. "Each chapter outlines issues related to health and illness, cultural/ethnic identity, communication, spiritual/religious orientation, food practices, family relationships, birth and death rituals, etc."

Visit www.nurseweb.ucsf.edu/www/books.htm for more information.

Effective communication efforts
Humana is taking steps to incorporate culturally relevant messages in member and provider communications. These materials encourage members to make use of preventive care screenings and checkups and to comply with prescription medications.

Additionally, members can identify providers who meet their cultural and language preference through the Web-based Physician Finder Plus tool or via a contact center representative.

For more information about Humana's CDCD program, contact Steven Goldberg, M.D., M.B.A., director, clinical policy, Clinical Guidance Organization, Humana, at (502) 580-1612.

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