Hugh Lytle is founder and CEO, Equality Healtha Value Based Care leader helping independent primary care practices make the transition to VBC.
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While there is no one way to define ‘cultural competence’, there is one that predominates explanationshared by Georgetown University’s National Center for Cultural Competence, is “A set of congruent behaviors, attitudes, and policies that converge in a system, agency, or between professionals and enable that system, agency, or professions to operate effectively in cross-cultural situations .”
Cultural competence is crucial for successful health outcomes. When care is delivered with sensitivity and understanding of cultural influences and differences, it can improve the experience and outcomes for all stakeholders, including people, communities, healthcare workers, insurers/payers, and the entire American healthcare ecosystem.
Cultural diversity is reflected in different cultural beliefs, which can hinder the unified U.S. health care system. Social and cultural backgrounds influence beliefs, motivations and decision-making regarding health care.
Health equality goes hand in hand with cultural competence. When we achieve health equity, every individual has the opportunity to reach his or her full health potential, leaving no one behind because of social or socioeconomic conditions. Health inequality can be measured by differences in height and quality of life; rates of illness, disability and death; severity of the disease; and access to treatment.
Cultural competency training enables providers to gain a better understanding of the values of the community being served to achieve a better outcome. Cultural competence benefits the patient, the caregiver and the healthcare system. It improves understanding, communication and respect by building trust in any care plan.
Cultural competence in value-based care
A number of US healthcare organizations are exploring changes in the way healthcare is delivered and funded. For many years, the standard was the fee-for-service model (known as the ‘FFS’ model). FFS is a volume game where healthcare providers are paid based on the services they provide.
Through my company’s work helping primary care practices adopt a value-based model of care, I’m seeing more players in the industry move to alternative payment models, including VBC. In the VBC delivery model, providers, such as hospitals, physicians, and other clinicians, are compensated based on patient health outcomes; they are rewarded for helping patients improve their health.
Still, there remains a need for healthcare organizations (providers and payers) to actively prioritize health equity in their value-based models. For VBC to eliminate inequality, more payers and providers need to incorporate health equity – and cultural competence – into their VBC program designs and approaches.
Improving cultural competence in health organizations
What doctors often lack are the practical methods necessary to embed unique cultural preferences in their work with diverse cultural groups.
Cultural care training can provide increased awareness about cultural values, beliefs and preferences, and can also provide guidance on how to tactically embed cultural care approaches at the point of care to improve outcomes and reduce costs. Ideally, these trainings take place in person and involve the entire practice. Everyone in the practice has a role in making a patient’s visit inviting, inclusive, respectful, personal and customer-focused.
Takeaways from these trainings could include understanding population health and strategies for improving overall health status; recognition of how patient health behaviors influence the financial risks of patient populations; identification of community and state-specific health disparities; and an identification of the socio-economic challenges and community risk factors faced by disadvantaged populations. Ideally, caregivers gain insight into how to use the short time they spend with patients to embed respect, trust and a personalized approach in the point of care.
Collectively, it is critical for the healthcare industry to encourage and drive the delivery of care that is culturally competent, addresses health disparities and improves health equity. Today, that means caring for the whole person that is fully responsive to the needs of an individual, including health care needs, social needs, mental health needs, environmental needs, and economic needs.
The same principles and considerations apply to any industry or profession. Whether you are a doctor, medical assistant, nurse, lawyer, engineer or accountant, you need to do more than just provide quality service. We all win when we try to understand the social and cultural constructs within which we practice our given profession.
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