How Central Health’s New Healthcare Equity Plan Will Help Achieve Equitable Healthcare in Travis County
ABOUT CENTRAL HEALTH
In 2020, the Central Health Board of Managers began putting together a service plan to improve access to healthcare by building an equity-focused, comprehensive, high functioning, and affordable system of care to improve the health of the population in the economically challenged parts of Travis County. In 2022, Central Health approved a comprehensive Healthcare Equity Plan to best position to meet the evolving health-related needs of its population and work toward long-term solutions that maximize the use of community resources.
WHAT IS THE PROBLEM, AND HOW DO WE PLAN TO FIX IT?
Central Health completed a study in October 2021 to evaluate physician needs in Travis County. The study revealed a shortage of over 375 full-time equivalent physicians trained in primary, medical and surgical specialties, combined. The key findings include:
- In Travis County, there is an estimated shortage of physicians across primary care and most specialties.
- The physician shortage is projected to increase over the next five years due to population growth and the expectation that physicians will retire and/or reduce their clinical practice at 65 years of age or older.
- These county-wide shortages will continue to exacerbate delays in care for people with low income, commonly referred to as the “safety net” and impair Central Health’s ability to
- Recruit providers to sufficiently serve people with low income through the organization’s contracting structure
- Hire physicians that resemble the diverse population that exists in Travis County today and can care for residents in their language and through their specific cultural lens.
Goal of the Healthcare Equity Plan:
To develop an equitable system of care that is comprehensive and accountable, while maximizing the collective use of resources to serve Travis County’s vulnerable
THE FOUR MAIN STRATEGIC IMPERATIVES
ACCESS & CAPACITY
Increasing providers and care teams
Optimizing transitions of care
Enhancing engagement for enrollees and expanding enrollment in high-need regions
SYSTEM OF CARE
Joint service-delivery planning and timely sharing of healthcare data
BUILDING A HEALTHCARE EQUITY PLAN
The Healthcare Equity Plan is based upon three assessments:
- A community health needs assessment (CHNA)
- An extensive Voice of the Community in-person and virtual engagement; and
- A safety-net healthcare system capabilities assessment and clinical gap analysis.
The plan was initially presented to the Central Health Board of Managers Feb. 9 and formally adopted Feb. 23.
COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA)
Previously, a health needs assessment focused specifically on Travis County’s low-income populations had never been conducted. Using extensive data, Central Health now has a clearer window into the disparities faced by its patient population, including barriers to accessing care and managing chronic health conditions.
For the purposes of the safety-net CHNA, Central Health divided Travis County into 14 planning and assessment regions to understand healthcare needs at a more local level. These planning and assessment regions were developed based on census tract analysis and other characteristics, including geographic borders, level of urbanization, transportation resources, and population density.
THE VOICE OF THE COMMUNITY
Community members actively participated in the development of the Healthcare Equity Plan, providing valuable insight to the challenges of navigating the safety-net healthcare system and opportunities for long-term improvements. The Voice of the Community engagement is critical to health equity efforts for marginalized and underserved patients. This process highlighted factors influencing patient access, connectedness, continuity, and trust from those with lived experience as well as the groups who serve or advocate for them.
Their input as broadly summarized:
- People appreciated the opportunity to provide input
- MAP is making a positive difference in people’s lives
- There is a need for added education about benefits and resources
- Language barriers exist when accessing and navigating the system
- Wait time for appointments and patient provider communication are both critical issues for patients
PROFILE OF PATIENTS ENGAGED THROUGH THE VOICE OF THE COMMUNITY
Clinical Gap Analysis
Access to healthcare services across Central Health’s system of care was evaluated based upon eight clinical service categories. Overall findings indicate that each of these service categories exhibit significant or moderate gaps that represent opportunities to be addressed in the Healthcare Equity Plan. Findings specific to each clinical service category are summarized to the right.