Empowering Health Care Consumers
May 2021 – November 2022
For NYHealth, health equity is achieved when all people have the opportunities and resources they need to be as healthy as possible and no one is disadvantaged.
But in practice, patients—particularly people of color—are often marginalized rather than placed at the center of the health care system. Although all patients should be valued as partners, patients of color can face unique obstacles, including racism, bias, mistrust, and gaps in communication between patients and physicians. Engaging patients of color is an important step toward the development of a more equitable health system. To help ensure that patients’ priorities, preferences, and experiences guide efforts to create a more equitable health care system, NYHealth issued a Request for Proposals (RFP), “Patients as Partners: Advancing Equity.” Through this RFP, NYHealth is supporting projects that seek to implement system improvements, practice innovations, or interventions designed to give patients of color a meaningful role in their health care. In 2021, NYHealth awarded FAIR Health a grant to participate in this initiative.
Under this grant, FAIR Health piloted shared decision-making approaches that were especially relevant to patients of color. Shared decision-making—the process by which patients and providers decide on treatment, balancing clinical options with patients’ needs, values, and preferences—can better engage patients as partners in their health care and shows promise for improving health outcomes and reducing health care costs. In collaboration with Dr. Chima Ndumele, an Associate Professor of Health Policy at the Yale School of Public Health and a Faculty Associate at the Institute for Social and Policy Studies at Yale University, FAIR Health developed and disseminated shared decision-making tools that combined clinical information and cost data drawn from FAIR Health’s private claims repository. The project team conducted focus groups with patients and providers of color to identify health care conditions that were particularly important to communities of color: slow-growing prostate cancer, Type 2 diabetes, and uterine fibroids. Focus groups led FAIR Health to replace the originally anticipated topic of early-stage breast cancer with Type 2 diabetes because patients of color identified a greater need for shared decision-making support for this health issue.
FAIR Health also engaged patients and providers to test the tools and ensure they were culturally sensitive and relevant in addressing the most pressing needs and concerns of patients of color when navigating the health care system. A broad range of New York State health care and community partners—including patient advocacy groups, survivor groups, hospital systems and associations, medical societies, and individual health care providers of color—were engaged to promote and use the tools in practice. FAIR Health disseminated the tools on its websites, FAIR Health Consumer and FAIR Health Provider, through social media, and with patient ambassadors and champions. Additionally, FAIR Health developed and shared a report to describe patients’ and providers’ perceptions of the tools and highlight key program learnings.