How Healthcare Payers Can Leverage Technology to Lead the Charge in Health Equity

For millions of Americans, race, income, geography, disability, and language barriers continue to determine whether they can access timely, affordable, and effective care. As a result, underserved populations still face disproportionately high rates of chronic disease, hospitalization, and complications as documented in the Institute of Medicine’s landmark Unequal Treatment report.

These health inequities are deeply entrenched in limited transportation, lack of health literacy, language barriers, and inadequate insurance coverage. If left unaddressed, the financial burden of these disparities could top $1 trillion annually by 2040.

In a bit of good news, government entities are starting to act with increased funding for health equity initiatives. For example, the Centers for Medicare & Medicaid Services (CMS) incorporated social determinants of health (SDOH) into quality measures and risk adjustment models. In 2027, CMS plans to introduce the Health Equity Index (HEI) into its Star Ratings, prompting payers to demonstrate measurable improvements in member outcomes. 

Unfortunately, regulation alone won’t close the wide gap in care that has been growing for decades.

This creates an opportunity for healthcare payers to be leading agents of change in the pursuit of health equity. Unlike providers who engage patients at distinct points in their care journey, payers have end-to-end visibility and are uniquely positioned to connect the dots across member data, healthcare delivery, and community resources, giving them a powerful platform to intervene.

To do so, payers must adopt a few new strategies. 

• First, payers must move beyond compliance and embrace a proactive, member-first approach to equity. That starts with capturing, managing, and interpreting data that reflects a member’s medical history, socioeconomic background, and preferences. 
• Second, payers must move beyond their historical silos with efforts fragmented across quality, clinical, and marketing teams. 
• Finally, organizations need to support this unified strategy with modern technologies that can scale outreach and personalize care.

One such technology is Artificial intelligence (AI). When deployed responsibly, AI-powered systems help payers build trust with members, enabling two-way, personalized engagement. For example, AI platforms can now support multilingual content, real-time appointment reminders, education on chronic conditions, and transportation assistance. These are all crucial tools for reaching members who may otherwise fall through the cracks.

The key is to use AI as part of a robust member engagement platform designed to create continuous, human-centered relationships. This is especially important for reaching populations where non-clinical factors (like food security or housing) have a greater impact on health outcomes than medical care itself. Member engagement platforms that emphasize omnichannel access and seamless service delivery can boost participation in preventative care and improve long-term outcomes, especially for those predisposed to chronic conditions.

Another advantage of leading member engagement platforms is that they support a wide variety of communication tools, from AI-powered SMS to live agent chat, emails to phone calls and even postcards. These options ensure that communication is tailored to the member’s preference and accessibility, while allowing for automated workflows that can enroll them in programs or content that are suitable for their needs. Just as importantly, these platforms support robust data, helping standardize the capture of race, ethnicity, and language information. By consolidating this data in a single system and sharing insights with providers, payers can coordinate care, close gaps, and support a more equitable experience for every member. 

The road to health equity is long and complex, but digital transformation offers a viable path forward. Payers that invest in equitable, member-centric solutions today will be better equipped to meet regulatory expectations, reduce costs, and improve outcomes across the board. With the right platforms, strategies, and partnerships, payers have both the opportunity and responsibility to lead the charge on health equity.

To read more about how payers can advance health equity, download TeleVox’s white paper on the topic at www.televox.com.