Connecting to Transform: Engagement as the Key to Addressing Health Equity and Achieving the Quintuple Aim

In recent years, we have seen an important shift in the healthcare industry—a heightened focus on health equity, underscored by the COVID-19 pandemic. This emphasis has given rise to several health equity-focused frameworks, including the Quintuple Aim, offering invaluable guidance for advancing health equity in healthcare systems and communities.

As a former leader at large national health plans, I have seen first-hand that health plans are instrumental in driving the system-level changes necessary to achieve the goals of the Quintuple Aim and advancing health equity. During my time working to help UnitedHealthcare and Optum develop and implement health equity strategies and programs, I observed several successful approaches and strategies, and what sets the most effective strategies apart is a common thread, which is a steadfast commitment to member engagement.

The evolution of the Quintuple Aim: health equity as the final element

The Quintuple Aim’s beginnings can be traced back to the 2001 Institute of Medicines (IOM) report, “Crossing the Quality Chasm.” In this report, IOM emphasized the need for safe, effective, patient-centered, timely, efficient, and equitable healthcare. Six years later, in 2007, the Institute of Healthcare Improvement (IHI) expanded on the six domains and introduced the Triple Aim. This concept placed improved member experience, improved outcomes, and lowered costs as the keys to healthcare transformation. Over the years, the concept evolved into the Quadruple Aim, with the addition of clinician well-being In 2021. When IHI added health equity to the mix in 2022, the Quintuple Aim was born.

Today, the Quintuple Aim has gained prominence as a comprehensive framework for addressing the evolving needs of the healthcare industry, making it a valuable guide for health plans interested in improving healthcare delivery and advancing health equity. 

Current strategies to address health equity and why they fall short

So, what are health plans doing to address health equity and achieve the goals of the Quintuple Aim? Initiatives addressing non-medical drivers like social determinants of health (SDOH) have become an important focus for health plans. In my time as a leader in population health, I have witnessed various health plan initiatives that meet members' non-medical needs, including initiatives that focus on alleviating housing and food insecurity, transportation, and community investments and partnerships.

Scene's recent health plan survey shows that collaborative partnerships, targeted outreach, and data analysis are top initiatives that drive health equity. Initiatives focusing on rural health or Federally Qualified Health Centers are also among the out-of-the-box initiatives health plans employ to improve health equity.

However, without solid member engagement, these efforts often struggle to foster active participation and achieve sustained improvements in outcomes.

Driving health equity through engagement: three guiding ideas

Member engagement can not be a haphazard addition to health equity programs and initiatives; it must be baked in. These three guiding ideas elaborate on the role of engagement in effective health equity interventions:

Engagement helps tailor Interventions to individual needs
To be effective, health equity initiatives must go beyond broad strokes and acknowledge each member's diverse circumstances, challenges, and aspirations. Tailoring interventions to individual needs ensures that health plans remove barriers hindering access to necessary care. Whether addressing language barriers, cultural differences, or SDOH, engagement is the bridge that connects health plans with the specific needs of their diverse populations.

Engagement empowers members to take control of their health
Shifting from a traditional, paternalistic healthcare model, health plans must actively involve members in their healthcare journey. Members should not be passive recipients but active partners in decision-making processes. This involves fostering a sense of ownership and autonomy, encouraging individuals to voice their concerns, preferences, and goals—and helping them do that when necessary. Through engagement, health plans can create a collaborative healthcare environment where members actively participate, leading to better, more sustained outcomes.

Engagement is enabled by technology
Telehealth, mobile apps, and remote monitoring tools can help engagement efforts transcend geographical gaps by extending care between in-person visits and providing continuous support. By embracing these technologies, health plans can expand the reach of their engagement initiatives beyond in-person interactions. Here, technology catalyzes accessibility and convenience, making healthcare more inclusive for individuals with diverse needs. Integrating innovative technology-based solutions can also ensure that engagement is not a one-time effort but a continuous process, adapting to the evolving needs of individuals and fostering lasting relationships.
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Looking forward

Integrating member engagement into every health plan program and initiative is foundational to cultivating a better, more equitable healthcare system that meets the goals of the Quintuple Aim. For health plan leaders, this work means that we’re doing more than just checking a box to meet state or federal regulations. We’re committed to making the healthcare system more inclusive and equitable for all. 

So as we look forward, let our collective focus remain on shaping a healthcare ecosystem that leaves no one behind.

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About the author

William Teague is the Vice President of Population Health at Scene Health. Prior to joining Scene William served in a number of key positions at UnitedHealthcare and Optum. He has more than 20 years of healthcare experience and has a breadth of knowledge that spans government programs, strategy, provider engagement, operations, and clinical and quality initiatives.