The Future of Health Equity: An Interview with Dr. Jay Bhatt, Deloitte Health Equity Institute
Priyanka Toddywala, ’24 chats with Dr. Jay Bhatt, Deloitte’s Health Equity Institute and Center for Health Solutions Executive Director and practicing physician in the Chicago-metro area.
Dr. Jay Bhatt, D.O., MPH, MPA is a physician executive, internist, geriatrician, and public health innovator. As Executive Director of the Deloitte Center for Health Solutions (DCHS) and the Deloitte Health Equity Institute (DHEI), Dr. Bhatt directs the research and eminence agenda across the life sciences and health care industry while driving high impact collaborations to advance health equity. He is a prominent thought leader around the issues of health equity, health care transformation, and innovation. Passionate about patient care, Dr. Bhatt will continue practicing medicine at local community health centers in Chicago and Cook County while serving in his leadership role at Deloitte.
PT: How is Deloitte defining and investing in health equity?
JB: Health equity is more than equal access to care. We define health equity as the ability to fulfill our human potential in all aspects of health and well-being. To do it, we’re creating cross-sector collaborations and tools aimed at addressing disparities in the drivers of health, racism and bias, and structural flaws in the health system. Our initiatives aim to help everyone achieve their full potential in all aspects of health, building a more equitable future for all. The Deloitte Health Equity Institute is committed to helping break down silos to advance equitable health outcomes at scale by driving action through community collaboration, analytics and insights, and knowledge and evidence capabilities.
Society cannot eliminate bias and structural racism in health unless we align strategies, policies, and investments. It’s time to engage in these tough conversations and challenge leaders to intentionally and deliberately design and build systems that advance health equity as an outcome. We are committed to being a catalyst for this change and helping organizations drive a sustainable and impactful health equity agenda from the ground up. We envision a world in which health equity isn’t determined by your race, gender, ability, status, or zip code, but one where everyone has a fair and just opportunity to achieve their full potential in all aspects of health and well-being.
PT: Can you talk about Deloitte's Health Equity Institute and its purpose?
JB: At Deloitte, equity is a core component to our business and drives positive societal impact. Deloitte US’s ambition is to set the standard for diversity, equity, and inclusion by fostering a culture and the systems that allow everyone to be empowered to thrive as their exceptional self and reach their full potential.
In addition to publishing our first Diversity, Equity, and Inclusion Transparency Report last year and are making a $75 million investment to fuel greater racial diversity through our Making Accounting Diverse and Equitable (MADE) initiative, Deloitte established the Deloitte Health Equity Institute (DHEI) in 2021 to help make health more equitable. To further advance equity, Deloitte announced a $1.5 billion investment in social impact over the next ten years, with health equity as a core focus. DHEI is a new arm of Deloitte dedicated to serving as a catalyst that moves the field for public good and advancing equitable health outcomes at scale, reinforcing Deloitte’s purpose of making a positive, enduring impact that matters.
PT: What is the most challenging part of infusing health equity into everyday business decisions?
JB: There are deep structural flaws in our health care system – gaps in availability, affordability, and coverage create barriers to equitable health care for lower-income, higher-risk individuals. Some of the top challenges we’ve heard from health care executives include:
· Leadership prioritization: Failure to prioritize health equity at the top leadership level inhibits the advancement of health equity. Health equity should be a core component of all business areas; however, this cannot be achieved without buy-in and prioritization at the top level.
· Demonstrating ROI: Demonstrating the return on investment (ROI) for social interventions remain a challenge because traditional methods of ROI analysis do not consider social, economic, and environmental factors, or value of the public good generated. This in turn leads to underinvestment in interventions that address the drivers of health, thus inhibiting the advancement of equity.
· Health care incentives: The US health care system is not designed to address the drivers of health that lead to health inequities and poor health outcomes. This poses challenges for health care leaders in advancing health equity because they are not incentivized by payers to improve equitable outcomes or address the driver of health.
· Quality, interoperable, and standardized racial and ethnic data and metrics: COVID-19 exposed that there is a need for access to high-quality race and ethnicity data as a first step toward advancing health equity – but there are barriers that exist. Historically marginalized people may worry that providing racial and ethnic data will create further harms in the form of discrimination, biological explanations of or blame for inequities, and inappropriate or differential treatment. Additionally, there is a lack of metrics to properly identify or quantify health equity strategies, infrastructure to seamlessly share data across platforms, and standardized categories to capture the data.
· Workforce shortage, bias and diversity: COVID-19 highlighted the industry’s staffing shortages due to unprecedented levels of burnout and attrition, with nearly half of clinicians experiencing high levels of burnout, according to our report. Bias and racism, both explicit and implicit across individuals and institutions, can also inhibit the advancement of health equity and lead to worse health outcomes for patients.
· Consumer literacy and trust: Literacy gaps are high among populations already facing especially poor health outcomes such as disparate ethnic groups, low-income individuals, and the elderly. Historical atrocities (e.g., the Tuskegee Syphilis Study) fueled distrust in the Black community, which is amplified by everyday racism, negative personal experiences (like those of my former hospital roommate), rumors, or traditions.
PT: What is your piece of advice for managers and executives who consider equity to be a tradeoff to profitability?
JB: While health equity is an issue that all stakeholders have moral obligation to address, there is also a business case to be made in improving health equity. For example, decreasing health disparities by advancing equity could lower health plans' and systems’ costs associated with poor health outcomes that lead to more emergency room visits, more neonatal intensive care unit stays, longer hospital stays, and unnecessary hospitalizations. This in turn could generate value for the businesses that pay for health care as well as state and federal agencies and the people they serve.
Leaders need to re-evaluate profitability or ROI for health equity. The current challenge is that standard ROI analysis is too focused on the near term and too narrow in scope to capture the full benefits of investing in health equity. Therefore, health care leaders need to evaluate ROI over a longer time horizon of three to five years; (2) take into account indirect returns to health equity investments, from enhanced brand appeal to improved employee engagement and productivity; and (3) weigh the strategic advantages that can flow from promoting health equity in an America where the population is becoming more diverse, the society is becoming more aware of and committed to addressing health inequities, and a future of health exists with empowered consumer.
Additionally, developing a common language can help us understand which programs have the most effective strategies and best outcomes for advancing health equity, as outlined in our previous blog. In turn, this information can help funders make investment decisions that more accurately and equitable address the needs of their members or patients.
PT: How can new healthcare startups incorporate equity from the very beginning?
JB: Leaders can take activate health equity in four key domains:
1. Do right by your people. How are we being representatives, allies and advocates within our own organizations to drive more equitable outcomes?
2. Examine the products and services from an equity lens. Who are we designing for? The types of offerings you create either advance or diminish equity. What intended or unintended outcomes are we creating in terms of health and economic equity?
3. Consider even further outward. How are we building and serving community? How are we connecting networks and resources to advance gender equity and better outcomes for the communities we are a part of?
4. Use the power of your organization: Use the power of its purse and the power of its voice to activate around equity? We form a collective whole that is vastly more powerful than each of us as individuals. How do we leverage that to create the fairer and more just world we’d like to see?
DHEI’s Health Equity Strategy Playbook further outlines steps an organization can take to define their health equity strategy to drive change and impact in the communities in which they serve.
PT: How do you envision a future for the equity in healthcare?
JB: Deloitte’s Future of Health™ vision centers from a shift in spending from care and treatment to health and well-being. New business models, technological breakthroughs, consumers armed with highly personalized data, and regulations that encourage change could lead to a dramatic deceleration of health care spending by the year 2040.
Additionally, the way in which health care is delivered is driving more opportunity to increase access to health care. Our report, advancing health through alternatives sites of care, highlights the role alternative sites, like retail clinics, can be used to expand access to care. I expect these non-traditional sites to become more prevalent in the future as consumers increasingly demand more convenient and affordable options.
Our research suggests the potential power of a hybrid model of care where virtual and affordable options are integrated seamlessly into workflows and patient encounters. And clinicians and peers (friends/family) that consumers know can help navigate care both in person and virtually. We could harness the power of trust to yield cost-effective, convenient options that might offset cost pressures in a year where affordability and inflation are on everyone’s minds.
Every organization should plan to address health inequities by designing and enabling the future of health care around people and equity. Health care incumbents, industry disruptors, community organizations, and government agencies each have a role to play in removing the barriers that lead to health inequities and turning unaffordable costs into opportunities. This should include intentionality in design, rebuilding trust, partnerships, measurement, and addressing individual and community level inequities.
PT: What are some examples of impact Deloitte’s Health Equity Institute has made thus far?
JB: Below are a few examples of the impact DHEI has made:
· Maternal Health (Maternity Care Desert Dashboard): To combat the prevalence of maternity care deserts, March of Dimes, a leader in the fight for the health of all moms and babies, has collaborated with the DHEI to launch the Maternity Care Desert and Health Equity Interactive Tool, a new insights dashboard that will make information available about maternity care access for women in the United States and will guide healthcare stakeholders as they work to provide necessary care to at-risk women and babies. This public-facing tool can be used by Federal, State, Local, Academic and other stakeholders to support the identification, education and resource alignment to combat the maternal health crisis afflicting women and children in the United States.
· Catalyze Health Equity Cohort: Catalyze Cohorts are an investment mechanism of the venture philanthropy organization, New Profit, that supports organizations addressing systemic inequities. Deloitte is providing financial support and pro bono services to help New Profit curate and run the programming of its Health Equity Catalyze Cohort, a collaboration with Deloitte that supports an initial eight organizations working to shift the underlying conditions that produce health inequities across an individual lifespan and generations. The eight organizations selected for the cohort will receive a one-year $100,000 investment of unrestricted resources, in-kind capacity building support, and participation in a peer learning community through a collaboration between New Profit and DHEI.
· Morehouse School of Medicine: DHEI gifted the Morehouse School of Medicine $1.1 million to drive efforts related to workforce development and maternity care. DHEI will also support MSM to establish a Center for Workforce Inclusion and Excellence and expand its Center for Maternal Health Equity to create training platforms for providers, educate patient navigators, and increase maternal home-based blood pressure monitoring for patients.
About the Author:
Priyanka Toddywala is a first-year MBA student at Northwestern’s Kellogg School of Management. Prior to Kellogg, she was a Strategy & Analytics Senior Consultant at Deloitte, working with federal government agencies on digital health, regulatory science, artificial intelligence, and health equity. Priyanka is passionate about leveraging innovation, policy, and business models to transform the health ecosystem towards equity.