For CEO Bernard Tyson, treating the dozens of populations that make up Kaiser Permanente’s 11.8 million members is not about ensuring equality of care. It’s about providing equity in care.
“We work on it every single day,” Tyson said. “There may be differences in how you think about delivering care to different populations. We have evolved from thinking it’s about equality of care as a measurement. I need to figure out what you need, as opposed to making sure you’re getting the same thing as everybody else. We can all do more of that in the health industry.”
A focus on health equity sits at the core of many of Kaiser’s innovations and practices, whether it’s reducing diabetes in African Americans through community outreach or building an electronic medical record system for patients that are culturally attuned to differences in races, languages and sexual orientation and gender identity.
In the last few years, Kaiser’s focus on LGBTQ-specific health care has increased steadily.
All 38 of Kaiser’s hospitals have been recognized by the Human Rights Campaign Foundation for being a leader in LGBT Healthcare Equality, and it’s a top title Kaiser has held since 2010. Since participating in the Health Equity Index since 2008, it has moved up the ranks for consistently having non-discriminatory patient and employee policies that include sexual orientation and gender identity, guaranteeing equal visitation rights for same-sex partners and parents and providing LGBTQ health education for its staff.
“HRC celebrates Kaiser Permanente for its work to create an inclusive and welcoming environment for all patients,” said HRC President Chad Griffin earlier this year in awarding Kaiser’s health-care designation again.
More recently, Kaiser in 2013 opened two Bay Area specialty clinics for treating trangender patients: Gender Pathways at its San Francisco Medical Center and the Multi-Specialty Transitions department in Oakland. Both centers offer a range of services in hormone therapy, surgical evaluations and procedures and psychological services. The two clinics also serve as a resource within Kaiser’s integrated system, wherever transgender members and staff are working together to get care.
“We focus on providing to transgender populations and it has so many challenges because of law, including understanding the nuances of how people identify themselves from a medical and surgical standpoint when they want to transition,” said Dr. Ronald Copeland, Kaiser’s chief diversity officer.
Recognizing Kaiser’s continuing commitment to LGBTQ health care, it is the Business Times’ 2017 Corporate Price award recipient.
Why culture matters
Copeland said Kaiser’s deepening involvement in LGBTQ health grew out of its Institute for Culturally Competent Care, which started in 1999.
Today, Kaiser separately oversees a dozen Centers of Excellence, now called cultural care centers, aimed at producing data and population research projects to improve patient health outcomes. Research shows patients facing language barriers and negative stereotypes sometimes end up skipping appointments or avoiding treatment, which eventually becomes an added cost to health providers. The centers also provide 24-hour translation services for members and staff in more than 100 languages. The majority of the centers are based in California because it’s such a diverse region, Copeland said.
“What we learned a long time ago is the importance of culture,” he said. “The first several (centers) had to do with African Americans, Latino and Chinese patients. But in more recent years, we’ve expanded to LGBT and women’s health.”
Copeland, who became head of diversity four years ago, said increasing diversity and inclusion at Kaiser is more than just about promoting it. For example, Kaiser is changing its health records system in 2018 to give patients the option to self-identify their sexual orientation, gender identity, disability and veteran statuses. The system already includes data on patients’ race, language and ethnicity, and expanding the metrics helps build a better picture of all patients.
“I felt that for us to take our game to the next level, the next step was defining cultural diversity and creating a playbook for how to get there.You have to have measures sophisticated enough to see if you are leaving any major populations behind,” Copeland added.
Kaiser’s many associations and employee resource groups have been recognized not just for their work in the community, but leading the way in health care for establishing an LGBTQ ERG as part of Out & Equal’s network. Kaiser joins some of the largest corporations on the list, including Visa and General Electric, in sharing resources and learning the needs around LGBTQ-friendly policies.
“Because of these associations in Kaiser Permanente, we’ve learned much more about how to be better at caring for the community, and that’s very rewarding,” Tyson said.
The KP Pride employee group formed in 1992 and includes about 500 employees in Northern California. The group has awarded more than $1 million in scholarships through the eQuality Scholarship Collaborative to support California students in their service to the LGBTQ community.
“It plays an important role in promoting professional development and helping the organization achieve its objectives of workplace diversity, culturally competent care, growth in diverse markets, leadership development, community benefit and supplier diversity,” said Janet Liang, president of Kaiser Permanente Northern California.