New UHF Report Details Ways for Health Insurance Plans to Improve Health Equity

Bringing Vast Resources and Health System Role to Bear in Addressing Disparities

NEW YORK, NY—May 9, 2023—A report released today by United Hospital Fund details the many ways health insurance plans can leverage their large resources and the unique role they play in community efforts addressing health inequities. 

Health plans are uniquely positioned to address health inequities as they are major employers, touch all aspects of health care delivery, and control a huge amount of spending that goes beyond the health care delivery system. In 2020, major New York-licensed health insurers reported over $15.8 billion in total assets invested and over $45 billion in revenue (not counting specially-licensed insurers focused on public programs or those licensed in other states that sell coverage in New York).

Leveling Up: A Role for Health Plans in Improving Health Equity in New York, provides numerous examples of interventions insurers are already taking, or can take, to improve health equity in New York and other states. Among the areas in which companies can incorporate equity principles are procurement, benefit design, provider networks, utilization review, internal diversity programs, public reporting, data collection, and investments to meet capital and social needs of communities and enrollees. 

“It’s been 20 years since the publication of the landmark Institute of Medicine report, Unequal Treatment: Confronting Ethnic and Racial Disparities in Health Care, laid out the shameful inequities in our health care system,” said UHF President and CEO Oxiris Barbot, MD. “The COVID pandemic made it painfully clear that scant progress has been made. It will take an all-hands-on-deck approach by all parties to bring about the structural change necessary to address social drivers of health. This report presents some important opportunities for health plans—which have a unique and vital role to play—as well as policymakers, regulators, and employers.”

Many—but not all—of the examples cited in the report grow out of Medicaid and Medicare rules, but employer-sponsored insurance plans can also address pressing needs. The most common public insurance initiatives identified in the report seek to address food insecurity and other social needs, most often through partnerships with community-based organizations. 

Regulators also have a role to play. For example, when BlueCross BlueShield insurers in western New York and Pennsylvania announced plans to affiliate in June 2020, state regulators made the agreement contingent on the combined companies committing $10 million toward improving racial and health inequities, the first time such an equity-based requirement was included.

Other equity-focused interventions highlighted in the report include:
•    A Massachusetts plan which reports annually on its 20-year-old effort to improve supplier diversity and create a level playing field for potential vendors.
•    New York City- and Buffalo-based plans that support programs to train local residents in the skills they need to join the companies’ workforces.
•    California insurance regulators facilitating socially responsive investments by insurers. 
•    The New York subsidiary of a national, for-profit plan that made a $750,000 grant to help federally qualified health centers train and hire community health workers. 
•    An upstate nonprofit plan that raised wages for lower-paid workers above the state minimum wage.
•    A New York City plan that partnered with a major hospital system to address “health harming” legal problems faced by enrollees.

“In many ways, the task at hand is best described as ‘leveling up,” said Peter Newell, author of the report and UHF’s Patricia S. Levinson Fellow. “It means encouraging plans to put their resources to work helping communities improve economic opportunity and address social needs, and working to transplant effective, equity-focused programs from one market segment to another, and from one health plan to others.” 

The report can be downloaded for free from UHF’s website here. It was supported by a grant from The New York Community Trust.

About United Hospital Fund

United Hospital Fund works to build an effective and equitable health care system for every New Yorker. An independent, nonprofit organization, we are a force for improvement, analyzing public policy to inform decision-makers, finding common ground among diverse stakeholders, and developing and supporting innovative programs that improve health and health care. We work to dismantle barriers in health policy and health care delivery that prevent equitable opportunities for health. For more on our initiatives and programs please visit our website at and follow us on Twitter.

May 9, 2023
Focus Area
Coverage and Access
Health Insurance Project