The Importance of Value and Equity in Health Care

Written by David L. Callender, MD, president and CEO of Memorial Hermann Health System, and Stephen J. Spann, MD, founding dean of the Tilman J. Fertitta Family College of Medicine at the University of Houston

As leaders in health care and health research in Houston, we at Memorial Hermann Health System and the University of Houston strive to keep our finger on the pulse of the region’s health issues. That’s why our two institutions recently partnered with the Houston Business Journal to survey local business leaders’ perspectives on the state of the health care industry, their understanding of value in health care and their perceptions surrounding health equity.

The survey revealed that Houston business leaders, especially larger employers, have a favorable impression of the health care industry overall, and are increasingly aware that health care providers are embracing value-based care. Three-quarters of those surveyed were at least somewhat familiar with the term “value-based care,” and the number who were aware that health care providers are transitioning from a fee-for-service model to a value-based model has doubled since 2020. With this increasing awareness, the number of companies incorporating a value-based approach in their health plans has grown by 27% since 2020.

Value-based care, or value, means achieving the best outcomes and experiences at the lowest cost. It places an emphasis on outcomes, patient experiences, cost-effectiveness, and health equity and incentivizes health care providers to prioritize preventive care, early intervention, and patient engagement. A focus on health, in other words — not just health care.

This approach can lead to a reduction in hospital admissions, improved management of chronic diseases, and a focus on overall wellness versus simply treating illnesses as they arise. All of this doesn’t just save money, it improves the quality of people’s lives.

Health equity, which is where every member of the community has the opportunity to be as healthy as possible, is a key component of health care’s value journey. Today, health care outcomes in the U.S. rank the lowest among all wealthy nations. One of the major drivers of this is the significant health inequities between different segments of our population. For example, there is a 19.3-year difference in life expectancy between the ‘healthiest’ and ‘unhealthiest’ ZIP codes in Harris County.

Research shows that non-medical drivers such as socioeconomic factors, the physical environment and differences in behaviors and lifestyles account for 80% of preventable disease and death in our country. To achieve value in health care, we must address these non-medical drivers upstream to improve health downstream, preventing illness and disease and their associated high costs.

Driving health equity begins with understanding it, and the survey results show that approximately half of business leaders understand health equity as access for all, regardless of race, socioeconomic status, or any other criteria.

At the same time, a majority of employers also recognize that issues surrounding health equity could impact their employees. For local employers, large and small, lower health care costs and improved productivity accounted for over half of the perceived benefit of health equity. When asked how to promote health equity, top suggestions from respondents were to offer opportunities for employee engagement with management, provide a safe platform for employees to make their voices heard, and create more inclusive workforce policies.

Business leaders can be a catalyst for improved outcomes in health care. And while great strides have been made in recent years, this survey also highlights opportunities for leaders across Houston to consider value-based care, including health equity, as key to the health of all Houstonians. After all, a healthy population underpins a healthy workforce, which in turn fuels the economic engine that allows Greater Houston to continue to grow and thrive.

Improving Houston’s health and well-being will involve the entire community, including health systems, educational institutions, elected officials, insurance companies and employers. By joining forces, we can make Houston a healthier place for us all.