By Laura Hennen - Public Relations Principal | Digital and Social Engagement

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Cultural understanding starts inside

March 15, 2018

While Minnesota is one of the healthiest states in the nation, it is also a state of great disparities. Opportunities to be healthy are greatly lacking in many Minnesota communities, communities of color, people of lower income and in rural areas.

Responding to this challenge is a critical business priority for Blue Cross.  Through strategic planning to create a diverse and inclusive workplace, Blue Cross aims to have employees who embrace a variety of perspectives, while also reflecting the diversity of our members.

A key part of this working is being done by using the Intercultural Development Inventory (IDI) assessment, a tool used by thousands of organizations around the world to improve intercultural competence.

We sat down with Paula Phillippe, senior vice president of human resources and corporate social responsibility, to understand why and how Blue Cross is using the IDI as part of its health equity strategy.

When and why did Blue Cross implement the IDI?

At Blue Cross, we know that these disparities and their causes are interrelated. We also know that closing the health gap is critical to our business and to our mission. That’s why very early in our corporate social responsibility strategy development Blue Cross named health equity as a key focus area.

In doing this, we talked about two key things. First, we discussed how to activate communities to make healthy changes. And second, we knew that to be successful, we had to get it right from the inside out. We recognize that we are not very diverse as an organization— though we are becoming more diverse— and need to build our competency for accepting differences.

That’s where the IDI came into place. We chose the IDI based on the recommendation of employees in the Center for Prevention, an area of our business that has long used this assessment in their work.

The key to the IDI is a level of understanding that everyone is on this continuum of cultural competence. Where you land is not a statement of judgement, it’s just a statement of development. By taking the IDI, an individual can assess how they perceive, understand and manage differences. The IDI also allows an organization to see their larger cultural picture, creating a common framework to help inform the larger strategy.

What has been the most key learning in the work with Blue Cross employees?

This assessment gave us a common language to help our organization have a holistic understanding of health equity, as well as to begin to help educate employees how equity differs from equality.

To this point, it is very common for people to land in a phase known as “minimization”, which is the idea that treating everyone equally is most appropriate. That’s a very logical and normal way to think.

However, when you’re working to build programs based in equity, you need move away from that idea of equality being best. It’s important to adjust what you’re doing to understand, accept and work with differences. That understanding comes further down the continuum.

By understanding equity verses equality, an organization can begin to shape strategies and actions based on each person or group’s differences.  By having a common language created by the IDI, Blue Cross is beginning to create an environment that is more inclusive for people of different ideas, styles or communication approaches.

Have you seen any really standout examples the IDI at work within Blue Cross?

Some leaders in our health services area who took the IDI are already working directly with our members who receive care management, considering things like cultural differences, for example. After taking the IDI, a group of employees who work directly with Blue Cross members went out and visited various communities to meet with providers who serve Blue Cross members. This helped them gain a new perspective on how different types of health care providers cared for patients, including insight into things like cultural norms. 

The focus on health equity also spurred a Ramsey County pilot that focused on supporting women with high risk pregnancies. By connecting Blue Cross care managers with the Ramsey County social workers, the program helped mothers-to-be get adequate prenatal care and services needed to be more likely to deliver healthy babies. (We shared highlights of this pilot in this blog post.)

Where do we go from here?

We were intentional in rolling this out first to our senior leadership team, as that has helped the company create a common framework and understanding. All new senior leaders now take the IDI as part of their onboarding and we’re continuing to expand it throughout the business.

This is just the beginning of starting to work differently, and we’ve already learned a lot that has helped Blue Cross understand where we are as an organization.

What is your greatest hope for the future based on what Blue Cross can learn from the IDI?

My hope is that Blue Cross can continue to shift the cultural thinking away from the idea that everyone should treated equally; and move to understand that people are different and make strategic decisions based on those differences.

We recently finalized and approved a health equity policy, which was a very important step. We need continue to look at how to embed health equity into our consumer experience. For example, we need to look through a health equity lens as we work with our Medicaid members and make decisions as we develop care management processes.

This will require Blue Cross to hardwire this framework into how we do businesses. But, the good news is that Blue Cross has an 85-year history of fulfilling a mission to make a healthy difference in people’s lives, so I feel confident the organization will boldly go forward to serve Minnesota’s increasingly diverse population for the next 85 years and beyond.

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