Traditionally offering virtual care and navigation services to employers, Included Health is now moving into the health plan space. It is teaming up with Point32Health to serve its commercial members in the LGBTQ+ community, companies announced Wednesday.
Based in San Francisco Health included gives patients access to virtual and in-person urgent care, primary care, behavioral health and specialty care. It also provides personalized navigation and advocacy services for the LGBTQ+ community and the black community. Point32 Hello, meanwhile, is an organization combining Harvard Pilgrim Health Care and Tufts Health Plan that cares for people in the Northeast. The organization serves more than 2 million membersalthough it is unclear how many identify as LGBTQ+.
Point32Health will now be able to offer members access to the Included Health LGBTQ+ Health navigation and advocacy program for LGBTQ+ members. These members will have access to a care team led by LGBTQ+ Care Coordinators who can help them find gender-affirming network providers. They can also be connected to support groups and receive medical and legal education. The Services are available via web and app.
“They will be congratulated [by] someone like them, someone in the same community who may have had a similar life experience or faced many of the same health care challenges that members come to us for,” said Colin Quinn, President of Communities at Included Health. “Whether it’s a parent looking for care for their child or wants to talk to someone because their child just came out, or maybe it’s a trans person navigating their gender confirmation surgery and needs for help understanding benefits and coverage.”
Tufts Health Plan members began getting access to LGBTQ+ Health on January 1, while Harvard Pilgrim members will get access later in the year. The partnership differs from that with SCAN Health Plan, which created a separate health plan for LGBTQ+ seniors. With Tufts Health Plan and Harvard Pilgrim, Included Health’s LGBTQ+ health services will be built into existing commercial members’ offerings.
LGBTQ+ members often have difficulty accessing care: 45% have difficulty finding a primary care physician, 60% have difficulty finding a mental health provider, 40% report negative health care experiences or discrimination, and 35% delay or avoid care due to negative experiences, according to Included Health research. The company is trying to move the needle on those statistics, Quinn said.
“As a result of this discrimination or negative experience, members say, ‘I don’t know who I can trust in the health care system. As a result, I will simply postpone or avoid my care. This is not a good thing,” he said.
Quinn, a gay man, has had his own struggles accessing care. A few years ago, he tried switching to pre-exposure prophylaxis (PrEP), a treatment to prevent HIV.
“I was looking for a doctor to prescribe PrEP,” he said. “The first doctor I went to really didn’t fully understand what PrEP was and actually shamed me for wanting to continue instead of supporting me, applauding me for this good decision I was making for my own personal health… I actually put it off and avoided my own healthcare for a bit because I was in my own head then.
Quinn’s experience led him to found Included Health in 2019, which was acquired by Grand Rounds and Doctor On Demand in 2021. The combined entity was rebranded as Included Health.
Health plans have a responsibility to improve access to health care for the LGBTQ+ community, Quinn argued. This will improve member satisfaction and reduce healthcare costs.
“There is a significant unmet need,” he said. “Something has to happen there. When there’s unmet need, what goes down is member satisfaction, the member experience… In fact, it’s better to ensure that members connect early with these established and clinically competent primary care physicians to reduce long-term health care costs over time,” he said.
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