BCBS MN CEO: Addressing Racism as a Healthcare Organization

Craig Samitt, MD, MBA outlines the anti-racism efforts BCBS MN has instituted and how other companies, even those outside the healthcare sector, can address racism as a public health crisis.

A recent poll from Blue Cross Blue Shield of Minnesota (BCBS MN) found that 42% of Minnesotans say that racism is "not a significant problem."

These survey results come months after the killing of George Floyd by a white Minneapolis police officer and the nationwide protests that followed, as well as during the COVID-19 pandemic, which has exacerbated longstanding racial and ethnic health inequities.

The poll also found that while 64% of Black, Indigenous, and people of color in Minnesota consider racism a public health crisis, nearly 60% of white Minnesotans disagree.

"Sadly, I would say that I'm not surprised by the numbers," Craig Samitt, MD, MBA, president and CEO of BCBS MN, said in a recent interview with HealthLeaders.

Despite the findings, BCBS MN is actively taking steps to help Minnesotans understand that racism is a public health crisis, a declaration that the organization made in 2020.

"We don't have to look much further than understanding the impact of racism and the effects on the disadvantaged folks in our community that has come from COVID," Samitt said. "In many respects, racial disadvantages and social determinants of health (SDOH) have increased the likelihood of sickness and death of people in our community."

Samitt said this dynamic is why BCBS MN's work is so important; not only is it a payer-provider organization that aims to deliver equitable healthcare, the company can also use its business model to encourage leaders and communities to address racism and health inequities.

"The impact of racism on health is expansive, and frankly, much greater than we have historically recognized or, frankly, been willing to admit," Samitt said. "The mission of Blue Cross is to focus on high quality, sustainable, affordable, and equitable healthcare, [but] we are missing a huge driver of poor health and inequities if we ignore the impact that racism has on the health."

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He added that it's been a devastating year "for all of us," but what is most devastating is the intersection of a health crisis with a racial crisis. If BCBS MN and other healthcare organizations think about health as just health, and not about SDOH, behavioral health, and racism, then those organizations are missing some of the key drivers of sickness and inequities.

While it's important for health organizations to focus on combating racism, Samitt said that society at large also needs to focus on racism for a number of reasons. Not only is it the right thing to do, but he also said that the highest-performing organizations are ones that allow employees to be their true and authentic selves and offer equal opportunities for growth and success.

"More specifically as it relates to health, I often have used the expression that 'an ounce of prevention is worth a pound of cure,' and, frankly, the healthcare industry has been living in the 'pound,'" he said.

Samitt said that the focus has been purely on sickness, which then rewards the industry with the perpetuation of sickness. If healthcare organizations focused on wellness and prevention, he said, then society would have less sickness.

"If we want to stand up for health, if we want to have a healthier community where every American has access to good health, not just good healthcare, we're missing a key driver if we don't truly, vocally, and substantively stand up against racism," he said.

Addressing racism internally and externally

Samitt shared several efforts BCBS MN is taking to combat racism within the organization, out in the communities it serves, and through partnerships with other stakeholders.

Internally, the organization is focusing on becoming an anti-racist organization, not just in words, but in actions, Samitt explained.

"Becoming an anti-racist organization is as much about changing policy within our organization as it is about changing hearts and minds," he said.

The organization has gone through extensive steps to ensure that they are listening and learning from their staff and being intentional about representation by examining diversity and inclusion in the workforce.

From the external side, BCBS MN has focused on community work across greater Minneapolis that addresses the barriers to health that the diverse populations are experiencing.

"Our focus is to support the community in understanding the impact of SDOH and improving the best possible health for the community by helping the community address it," Samitt said.

Related: BCBS MN CEO: Rethinking the Role of the Payer

The organization has also invested in its communities. In 2016, BCBS MN launched the Healthy Together Willmar Initiative, in which the organization committed $2 million for the small Minnesota city. BCBS MN has also contributed nearly $30 million across the state to advance health equity and address SDOH in disadvantaged communities, according to Samitt.

Recently, BCBS Minnesota has been focusing on improving its COVID-19 vaccination efforts for patients who are having trouble achieving access.

"The traditional community is vaccinating people through mass vaccination sites or through provider communities, and that is all very important," Samitt said. "But what we've complemented it with is a partnership with the state to establish a mobile vaccination program where we go out into the community, to those that may not have access to transportation, or may be to too ill, or be otherwise unable to follow the traditional path to get vaccinated."

The organization has also emphasized educating and supporting the community about the vaccine and creating a partnership with the community, as diverse communities are the most concerned about the vaccinations, Samitt said.

To that end, BCBS MN has committed $5 million to establish the Center for Anti-racism Research for Health Equity at the University of Minnesota.

"[The] goal is to develop evidence-based, anti-racist research to understand and measure the impact of racism on health," Samitt said. "We can't change what we don't know and we certainly can't change based upon biased assumptions."

It 'takes a village'

Samitt suggested that healthcare organizations that want to be proactive in being anti-racist need to start by looking within their own organizations.

"I'm a big believer in leading by example, and we can't become an anti-racist community if we aren't anti-racist ourselves within our own organization or within our own hearts and minds," he said.

When BCBS MN first looked within, Samitt said, the organization sent out a survey to employees to understand the degree to which they were affected by racism and SDOH.

Although the organization hypothesized that the survey would not reveal that the employees were affected as much as the surrounding communities, the results revealed the opposite, Samitt said, that their teammates were struggling just as much as patients.

From there, the organization could begin to change. By starting the change from within, BCBS Minnesota also sets up a good example for other organizations, Samitt said.

"[It] takes a village," Samitt said. "No singular organization can do it themselves … If the healthcare community worked together with the business community, with social service agencies, with the state, that we can accomplish anything. But we need to focus on it together not focus on it apart."

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