Advancing Health Equity at Elevance Health

A Review of Approach and Capabilities

March 2024

Executive Summary

• Elevance Health, Inc. ("Elevance Health") is an American diversified health services company offering health insurance plans and care solutions to approximately 47 million members.
• It engages BSR, a global nonprofit, to perform a health equity assessment to evaluate the company's approach and to offer recommendations for improvement.
• This report finds that Elevance Health has an integrated and mature health equity strategy and advanced practices among its peers, yet still recommends pursuing the National Committee for Quality Assurance Health Equity accreditation for all its health plans and continuing to mature its Whole Health Index.

1. Introduction 1.1 About Elevance Health Elevance Health is an American diversified health services company. It was formerly known as Anthem, Inc., but changed its name to Elevance Health in 2022. Elevance Health is one of the largest for-profit managed health care companies in the U.S., with approximately 47 million members. It offers a variety of health insurance plans, including commercial, Medicare, and Medicaid plans. Elevance Health also offers a variety of clinical, behavioral, pharmacy, and complex-care solutions.

1.2 Why a Health Equity Assessment? To reinforce the company's commitment to advancing health equity, Elevance Health engaged BSR, a global nonprofit that works with businesses to create a just and sustainable world, to conduct a health equity assessment. The assessment reviewed Elevance Health's services to discern whether their offerings create equitable outcomes that improve health for all regardless of age, race, ethnicity, sexual orientation, gender identity, disability, place of residence, and/or financial status. The assessment included a review of Elevance Health's thought leadership, the company's advocacy efforts, responsible artificial intelligence (AI) practices intended to help advance health equity, and engagement with internal and external stakeholders. The assessment aims to enable Elevance Health to further strengthen its commitment to health equity by identifying opportunities to integrate inclusive and equitable policies and practices into its service offerings.

1.3 Assessment Methodology BSR gathered and reviewed a wide range of information to understand Elevance Health's current approach to health equity and to identify areas for improvement. Initial research looked for trends in health equity and identified emerging issues. BSR reviewed public documentation such as website content, annual reports, impact reports, news stories, press releases, videos, and interviews with leadership to understand Elevance Health's health equity approach more deeply and to assess its progress against selected peers.

2. Elevance Health's Approach to Health Equity 2.1 Definitions Elevance Health uses the Robert Wood Johnson Foundation (RWJF) definition of health equity, defined as everyone having a fair and just opportunity to be as healthy as possible. This includes removing obstacles to health such as poverty and discrimination. It also includes acknowledging those obstacles' consequences including powerlessness and lack of access to good jobs with fair pay, quality education and housing, safe environments, and health care. Additionally, Elevance Health uses the following terms in the context of health equity:

• Health disparities are differences in health outcomes between groups of people.
• Health inequities are differences in health outcomes that are avoidable, unnecessary, unfair, and unjust.
• Social drivers of health include how and where a person lives and how they react to and interact with their community and physical environment.
• Notably, Elevance Health does not use the term "social determinants of health," as the organization believes this suggests that health is pre-determined-that nothing can be done to change a person's health situation. The term "drivers" demonstrates that people and communities can overcome or change such factors.

2.2 Health Equity by Design Elevance Health has committed to "health equity by design," an internal operational approach that allows for personalized, intentional interventions to ensure that all people can receive individualized care. "Health equity by design" strives to enable a comprehensive understanding of all members' needs by examining member data, analyzed within a community context; expanding and standardizing member data collection, analysis, and reporting; enhancing provider capacity, incentives, and accountability to advance health equity; identifying and scaling best practices to embed health equity into operations; and leveraging data, technology, and partnerships to address health-related social needs (HRSN).