Celebrating its 20th anniversary during National Minority Health Month, the National Hispanic Medical Association (NHMA) held its annual conference last weekend in collaboration with the Hispanic Dental Association (HDA). Topics for the several different workshops ranged from cancer and diabetes to increasing diversity in health professions and building a more successful practice.
NHMA President Elena Rios last Friday welcomed the D.C. crowd of healthcare professionals and medical and dental students saying Hispanics have seen the biggest decrease in uninsured rates under the Affordable Care Act. “We now need more education and outreach,” she said.
According to Rios, hospitals have been approaching NHMA looking for Spanish-speaking doctors and dentists. “We need to be able to identify and encourage the next generation to be of service in our Latino community,” Rios said.
HHS acting Assistant Secretary for Health Karen DeSalvo attended the opening plenary and named a few steps HHS is currently focused on, such as tying traditional fee-for-service Medicare payments to quality with alternative payment models and bundled payments. Medicaid programs and private payers have been coming along with the agency, DeSalvo said.
DeSalvo acknowledged that even the best healthcare system is only going to get us so far. The rest, she said, is non-medical determinants of health. “We need to step outside the healthcare box and think about public health.”
The three-day conference provided a lot of food for thought. Here are some takeaways.
U.S. healthcare system isn’t made for Spanish-speakers
Jeanette Contreras, acting director of the Division of Professional Affairs at CMS’ Office of Communications says the uninsured rate among hispanics dropped by 11.3 percentage points (a 27% decline) between October 2014 to February 2016 from 41.8% to 30.5%.
Contreras says CMS is working with consumer advocacy groups like the League of United Latin American Citizens, the National Council La Raza, and the National Association of Hispanic Nurses in order to increase opportunities for Hispanic providers as the number of Latinos/as in the country continues to grow. In 2014, Hispanics accounted for 17% (55 million) of the country’s total population, making it the largest ethnic or racial minority, according to a report from the U.S. Census Bureau. The report projected the Hispanic population will grow to about 119 million or 28.6% of the total population by 2060.
Daniel E. Dawes, author of 150 Years of Obamacare and co-founder of Health Equity Leadership & Exchange Network (HELEN), says more data with Latinos are needed to drive down the $300 billion the country is currently spending from the impact of health disparities.
He said 25% of the Hispanic population lacks health insurance coverage currently. “We have a lot more work to do to reach out to our communities here,” Dawes said.
The consensus among panel members was that the ACA has been working. “The ACA will continue to be the law of the land, no matter who is elected president,” said Anthem Medical Director Luis Estevez.
But more work is needed to advance Hispanic health. Some of the major challenges, according to Dawes, are increasing Medicaid expansion and improving quality measures. He says Hispanics experience poorer quality of care for about 40% of quality measures.
American College of Physicians President Wayne Riley said eight out every 10 Hispanics qualify for Medicaid, CHIP, or exchange plans and 8.8 million Hispanics with private insurance now have access to preventive services.
However, more Hispanics could gain coverage if they lived in states where legislators expanded Medicaid, Riley said adding, “A priority for us is that we have to continue to advocate for Medicaid expansion."
HIT is a hit!
Nick Hernandez, CEO of Florida-based ABISA, said technology is disrupting the marketplace and shifting the site of care. Health IT has the capability of improving the communication between providers and patients because it enables both interaction and comfortability, he says.
For IT adoption in a healthcare setting, which Hernandez says reduces delays in diagnoses and in treatment, he recommends:
A feasibility study or an operational assessment;
Developing a short- mid- and long-term plan; and
Training and marketing.
Consejo Sano, a Hispanic health platform designed for mobile and delivered by native Hispanics, provides general medical advice, information on managing diabetes, and video educational content to help users make better healthcare decisions for themselves and their families.
CEO Abner Mason says the app directs callers who need clinical support, navigating them along any customized path of escalation.
“Our engagement rates were in the double digits over the first three months and that's incredible for traditional telemedicine,” Mason said.
Some Hispanics are leading the way
“There is a growing need for healthcare providers to service the growing Latino population,” Cano Health CEO Marlow Hernandez says.
The question of how to get more Hispanic providers to service Hispanic patients remains unanswered. But some starting point could include removing barriers Hispanics may face when entering a healthcare profession or increasing mentorships.
Alison Gammie, director of the Division of Training and Workforce Development and Diversity at the National Institutes of Health, says a good mentor has the interest of the mentee in mind in terms of career development and well-being.
“It’s really taking each and individual person with their background and understanding them and helping them transition to the next step,” Gammie said.
In addition, Kayla Rodriguez, co-founder and COO of startup BioSweet in Memphis, offered a piece of advice after her presentation on opportunities for Hispanic health professional leadership, “Mentor somebody, please.”
“Reach out, give back, send the elevator back down and help bring the elevator back up because we have so much to learn from you (students) and we have so much we can teach you along the way,” Rodriguez said.