Incentives help bridge wide disparities
- Dr. Joseph Webb is chief executive officer of Nashville General Hospital
Health equity, defined as the attainment of the highest level of health for all people, emphasizes valuing everyone equally and undertaking societal efforts to mitigate avoidable inequalities and eliminate health and healthcare disparities.
This principle is particularly relevant in Nashville, where the 2018 Nashville Health Equity Report highlighted troubling disparities: Davidson County’s infant mortality rate was 7.1 per 1,000 live births, significantly higher for non-Hispanic Black infants at 12.6, compared to 4.2 for non-Hispanic White infants.
Similarly, heart disease mortality rates revealed racial disparities, with reports showing that almost half of African American adults in Nashville were diagnosed with high blood pressure, compared to just 27% of the white population.
This, coupled with the fact that African American adults are twice as likely to be diagnosed with diabetes than the general population, raises the question as to what more can be done to reduce the racial divide when it comes to health, and how the lives of future Tennesseans can be improved.
Notwithstanding, the COVID-19 pandemic has exacerbated these inequities, spotlighting the profound impact of social determinants on health outcomes in Nashville’s young, diverse population. Or, in other words, the fate of people of color was far more burdensome than it was for the white population. Racial and ethnic disparities in case rates, hospitalization rates and mortality rates have mirrored national trends, further underscoring the critical need for focused health equity efforts in the face of public health crises.
According to the Department of Health and Human Services Office of Minority Health, Black Americans are at greater risk for “COVID-19, heart disease, stroke, cancer, asthma, influenza and pneumonia, diabetes, HIV/AIDS, and homicide” than White Americans. Life expectancy from birth for Black men is 66.7 years versus 73.7 for White men and 74.8 for Black women versus 79.2 for White women.
This is the current state of health equity in Tennessee
In 2023, Tennessee found itself near the bottom of national health rankings, positioned 44th overall. The state also ranked 15th in terms of healthcare deserts, with 23 of its 95 counties lacking sufficient health services. These health care deserts affect more than a third of Tennessee’s population, impacting approximately 2.5 million residents.
Data from the CDC in 2022 revealed that obesity affects almost 40% of Tennessee’s population – making it the fifth highest in the United States. Consequently, In Tennessee, the diabetes crisis is widespread, with nearly 14% of adults — equating to 730,416 individuals — diagnosed with the disease. An additional 158,000 Tennesseans are living with diabetes unaware, and another 1.8 million are in the prediabetic stage, facing increased risks without immediate intervention.
The disparity in maternal health outcomes is also just as stark, with non-Hispanic Black women being 2.3 times more likely to die to pregnancy-related causes than White women, with mortality rates of 78.2 per 100,000 live births compared to 32.9 for White women from 2017 to 2021. Further disparities are seen in infant mortality, where non-Hispanic Black infants in the U.S. have a mortality rate 2.4 times higher than non-Hispanic Whites. Specifically, these infants are nearly four times more likely to die from low birthweight and other complications and 2.9 times more likely to suffer from sudden infant death syndrome in 2020.
Incentive program is getting patients care and saving them money
Socioeconomic status has long determined health outcomes across the country, consequently spiraling the mortality trajectory into the ground and leading to a national crisis and classifying over 80% of U.S. counties as health care deserts that lack essential health services.At Nashville General Hospital, dismantling socioeconomic barriers to healthcare — such as cost and access — remains a core mission. Launched 15 years ago, the Nashville General Hospital Metro Healthcare Incentive Program was specifically designed to provide Metro employees, their dependents, and pensioners not covered by Medicare with convenient, low-cost access to high-quality care.
The program effectively removes copays and deductibles for enrollees of the Metro’s Cigna PPO when they seek treatment at Nashville General facilities, including the soon-to-open Nashville Healthcare Diagnostic Imaging Center. The initiative extends to participants in Metro’s Cigna non-PPO and the Nashville Electric Service medical plan, offering substantial financial relief with potential savings of up to $2,000 annually.
Regular interactions with primary care providers, which are facilitated by programs like Nashville General’s, are linked to better health outcomes, including reduced mortality and lower healthcare costs, making such initiatives not only beneficial but essential.
Access to health care is essential for longer, healthier lives
In 2023, Nashville General Hospital’s Metro Healthcare Incentive Program became a beacon of hope and health for more than 1,600 Metro employees, family members, and pensioners, enabling nearly 6,000 visits to hospital facilities and accruing savings estimated at over $600,000 for the year.
Since its inception in 2009, the program has offered more than just financial relief, amassing an estimated $3.9 million in savings on copays and deductibles.
More importantly, it has opened the doors to accessible, quality healthcare, fostering a brighter, healthier future for Nashville’s working families and their younger generations, proving that proactive healthcare measures can indeed pave the way for longer, healthier lives across all ages.
The Nashville Healthcare Center opened in 2016 as a primary care practice with two family medicine providers.
In 2019, Nashville General Hospital opened the first offsite location in Midtown and transitioned all primary and specialty practices under the Nashville Healthcare Center brand.
Today, offering primary care and more than 23 medical specialties, the Nashville Healthcare Center is here for all Nashvillians and their families.
Our board-certified providers are dedicated to delivering patient-centered care with a strong focus on prevention and wellness. Other locations include Nashville Healthcare Center, Bordeaux and Nashville Healthcare Center, and MetroCenter.
Dr. Joseph Webb is chief executive officer of Nashville General Hospital
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