2023 marked MetaStar’s 50th anniversary, a significant milestone that we celebrated with gratitude and a commitment to giving back. As we reflect on five decades of pursuing our vision of optimal health for all, our dedication to the well-being of our communities takes center stage. This anniversary year has been more than a celebration – it’s been a year of meaningful contributions. Throughout the year, our team members gave back in a variety of ways.
Virtual Blood Drive with the American Red Cross
We partnered with the American Red Cross for a virtual blood drive. Aligning with our anniversary theme, our goal was to recruit and secure 50 donors. We’re thrilled to announce that we exceeded this goal! These donations help ensure a crucial supply of life-saving blood is available for community members in need.
Fall Donation Drive Supporting United Way and Community Shares
In the spirit of the season of giving, we organized a fall donation drive for United Way of Dane County and Community Shares of Wisconsin. The entire MetaStar team heard directly from individuals from Safe Communities of Madison and Dane County (supported by the United Way) and Disability Rights Wisconsin (supported by Community Shares) and learned about the important work both groups are doing to support our communities and help them thrive.
Empowering Team Members to Volunteer
As part of our commitment to community engagement, MetaStar empowered our team members to contribute their time through volunteer opportunities in their own communities. Our team rose to this opportunity by providing over 100 volunteer hours to support mission-aligned organizations. Below is a list of some of the organizations our team supported in 2023:
- Madison Street Medicine in Madison
- Ronald McDonald House Charities in Madison
- Safe Shelter in Green Bay
- Kinship Community Food Center in Milwaukee
- Second Harvest Food Bank in Madison
- SOAR Fox Cities in Appleton
- The Stoughton Wellness Coalition in Stoughton
- H.E.L.P. (Help Excite Little People) in Sauk City
- Meals on Wheels in Madison
- Project Christmas of Jackson County in Black River Falls
- Allied Family Center Boys and Girls Club in Fitchburg
As we celebrate our 50-year legacy, we remain committed to “walking the talk” by giving back to the communities we serve – now and in the years to come.
How we can improve health equity with culturally and linguistically appropriate services (CLAS)
Everyone deserves quality healthcare services. CLAS standards can help tailor care to the patient’s unique needs and help them feel included in their care. If we all do our part, we can move health equity straight to the head of the CLAS!
The CDC defines health equity as “the state in which everyone has a fair and just opportunity to attain their highest level of health.”* Health equity is a tenant of high-quality care and should remain a commitment for the entire healthcare community, as outlined in the overarching goals of Healthy People 2030.
Dr. Kedar Mate, the Institute for Healthcare Improvement president and CEO, challenges that there can be no progress on quality without equity. And yet, our data continues to highlight the gaps in care by characteristics such as race, ethnicity, socio-economic status, and geography. Commitment exists to provide equitable care and reduce disparities across healthcare organizations, requiring changes in policies and practices. Guidance is available to help build such policies and procedures and assist with staff education to get us closer to providing culturally and linguistically appropriate services (CLAS).
CLAS sets forth standards and guidelines to help healthcare organizations deliver culturally aware care, encompassing many aspects of healthcare delivery, including communication, language assistance, and organizational culture. Health services that are respectful of and responsive to the health beliefs, practices, and needs of diverse patients can help understand and break down barriers to ultimately close the gap in health outcomes.
Bias Is a Barrier
While many healthcare professionals are well-intentioned and dedicated to offering high-quality care, explicit or conscious bias as well as implicit bias—an unconscious association, belief, or attitude toward any social group—can be a barrier for building trust with patients.
How might incorporating CLAS standards improve the implicit bias in the following examples leading to improved care?
- A doctor diagnoses a Black patient with diabetes and focuses initial treatment efforts on nutritional changes—without first exploring if nutrition is a central factor in the patient’s condition; making assumptions about what the patient is eating due to their race.
- A nurse practitioner is surprised when a Hmong patient seems hesitant to try a treatment plan, not knowing that the patient is afraid to say they want to first try traditional healing practices.
- A nursing home administrator assumes they are being inclusive by putting up LGBTQIA+ posters throughout the facility but does not consider talking to the residents who are members of the LGBTQ+ population about what would make their care and stay respectful and inclusive.
Sadly, bias too often leads to inferior care that is not personalized or equitable. Without incorporating CLAS, providers may miss opportunities to provide even better care for their patients. The CLAS standards are a blueprint of 15 standards for individuals and organizations, providing simple, effective ways to address health equity, improve quality, and eliminate disparities.
Breaking Down Barriers
- Be intentional and involve your intended audience. When creating CLAS materials, it’s important to both identify the needs of your intended audience and validate those needs by involving those most impacted in the development and design of services. For example, when creating materials for a Spanish-speaking audience, it’s not always enough to rely on a translation firm’s expertise. Instead, involve people whose native language is of the Spanish dialect for the patients being served. Ask them to help you understand nuances among differing dialects. This can go a long way in creating materials that help patients feel welcome, heard, and understood.
- Educate your staff. Healthcare providers earn trust by showing they are knowledgeable and empathetic. Incorporate training, across the organization, to build cultural competency and reduce explicit and implicit bias. Our reach extends beyond our internal employees. We’re proud to partner with the University of Wisconsin-Madison effort on Community-Academic Aging Research Network (CAARN), which brings together community and health system partners with academic researchers to conduct research to improve the health of older adults and decrease health disparities.
- Understanding, and using, Z-codes. Z codes, which are a category of ICD-10 codes, represent reasons for healthcare encounters that are not related to disease, injury, or external cause. Instead, Z codes describe social, economic, and environmental factors that influence a person’s health. These codes include issues related to education and literacy, housing and economic challenges, and difficult family circumstances. By using Z codes, instead of merely identifying a patient as having diabetes or other ailment, patient files alert the physician to potential problems that may be affecting the patient such as poverty, homelessness, food insecurity, or other personal challenges that can shape the physician-patient conversation. By having this information at hand, healthcare providers may better avoid biases and misconceptions that stand in the way of the most effective care. It allows the provider to have the necessary information to focus on the unique patient in front them.
Providing equitable care is essential to improving the health of the communities we serve. Through a commitment to the CLAS standards, we can support cultural humility across the continuum of healthcare and move closer to the ultimate goal of health equity for all.
*What is Health Equity? | Health Equity | CDC
September is National Recovery Month, an annual observance to educate Americans that appropriate treatment and mental health services can help those with substance use disorder (SUD) live healthier lives. Sadly, this ideal remains difficult to achieve because of bias in how we view addiction in this country.
At MetaStar, we’ve identified stigma as a primary major public health challenge. Stigma can prevent people with SUD from seeking help, even if they desperately want it. Educational programs and policy innovations have helped, but there is still work to be done to help eliminate stigma and help those struggling with SUD.
Systemic issues work against those fighting addiction
Imagine SUD as a very large boulder a patient carries with them every day. Should this person also have a mental health disorder—which often is the case—this adds a second boulder. If they happen to be a person of color, they’re weighed down by three boulders. If they’re a woman, by four, and if they’re living in poverty, five, and so on.
Despite good intentions, the healthcare community struggles with systemic issues in deploying appropriate, evidence-based treatment to those who most need it for SUD, as well as additional challenges. We know there are effective treatment options, but the question remains: How do we get the right treatment, to the right patient, at the right time?
Too often, the healthcare community chases the latest “solutions,” such as smartphone apps, telehealth, and AI-supported tools without reflecting on a root cause—stigma—and how overcoming that can help pave a smoother road to recovery.
Overcoming stigma
Stigma continues to cast a shadow over efforts to provide effective treatment for those grappling with SUD. This pervasive, societal shaming creates barriers at every stage of the recovery journey:
- Structural stigma leads to discriminatory policies and practices, such as a devaluing of treatment care providers, treatment entry procedures designed to present hurdles to those who are seeking care, and limited insurance coverage.
- Continued stigma on the part of healthcare providers can lead to mistreatment of those seeking help.
- And lastly, as people internalize negative stereotypes, it leads to feelings of shame and worthlessness, making a person feel as if they aren’t even worthy of getting better.
The Shine a Light podcast, which focuses on reducing stigma, recently featured a guest from a rural area who described her experience when seeking help. After finding herself at rock bottom, she made the brave decision to go to the hospital emergency department for help. After waiting for six hours, she received a curt response from the first doctor she saw: “I know what you’re here for, and I know what you’re all about. You’re not getting any drugs from me, so you should just leave.” This devastating experience kept her from seeking help again for a long time.
Shine a Light on Stigma
MetaStar’s two tenets related to the reduction of stigma are simple:
- Knowing, understanding, and empathizing with those with SUD helps defuse the negative impact of stigma.
- Words matter.
Not everyone has the opportunity or comfort level to get to know someone who has experienced SUD. Through our work with the Superior Health Quality Alliance’s Shine a Light on Stigma campaign, we’re able to bridge that gap. We offer informative, frank and action-oriented videos and podcasts to help people recognize their own prejudices and learn how to change them, humanize those struggling with SUD, and evolve the language we all use in discussing SUD.
Words matter. Using patient-friendly, person-centered language is a critical step in reducing stigma. For example, referring to “a person with substance abuse disorder” conveys an entirely different message and tone than labeling this same individual an “alcoholic,” “addict,” or “drug abuser.” The former suggests the person has a problem that can be addressed; the latter implies the person is the problem. By using person-centered language, you can show respect and kindness to people who may need it the most.
Take the pledge to reduce stigma
Because stigma is public health challenge, it requires community support to change it. That’s why we ask people and organizations to pledge to use appropriate, empathetic language and encourage others to do so, as well. We’re proud that people from across the nation have joined us, and the number continues to grow. We’ll continue our efforts throughout National Recovery Month and throughout the year, because changing stigma happens one conversation at a time.
Jesi Wang
By: Jesi Wang, MetaStar President & CEO
MetaStar is celebrating 50 years of dedication, partnership, and progress in effecting positive change in health and healthcare. We enthusiastically look forward to a new era in healthcare quality and patient safety, while recognizing our journey toward optimal health for all is ongoing.
In 1999, the Institute of Medicine (now the National Academy of Medicine) released a landmark report: To Err is Human: Building a Safer Health System. It shed light on a sobering reality: Preventable medical errors were contributing to tens of thousands of deaths in the U.S. each year.
The research called out staggering systemic failings, including fractured communication, inadequate training, and a lack of standardization in medical practices. Further, it pointed to a need to fashion a “culture of safety” based on transparency, the ability to report errors without fear of retribution, and, perhaps most important, learning from mistakes.
Since that report, significant improvements have occurred, thanks to the dedication of healthcare organizations and professionals. This includes the widespread adoption of electronic health records (EHRs); improvements in medication safety; implementation of learning systems and error reporting; fostering cultures of safety; and advances in telemedicine and remote patient monitoring. Yet there is more to be done.
As we look to the future of quality and patient safety, six key opportunities exist to further effect change and improve the lives of the individuals and communities we serve:
1. Better engage patients as true partners.
We need to prioritize active engagement in decision-making, while fostering collaborative relationships between healthcare providers and patients, to ensure care is tailored to individual needs and preferences for improved health outcomes and overall well-being.
A best practice example is the Moving Forward Coalition, a trailblazing group of more than 120 individuals and organizations focused on nursing home reform that routinely calls on groups of nursing home residents to identify problems and propose solutions.
2. Harness the power of clinical data to improve decision-making and health outcomes.
Emphasizing interoperability between healthcare providers and communities will facilitate seamless exchange of information, enabling comprehensive patient profiles and a holistic approach to care. We must acquire better data rather than just more data to advance patient outcomes and introduce efficiencies in healthcare processes. We need to think creatively about better ways to analyze, gather, share, present, and use data so the focus is on improved healthcare outcomes and not only data capture and measurement.
There are solutions such as the Wisconsin Statewide Health Information Network’s (WISHIN) Pulse, a patient-centric, longitudinal community health record that enhances clinical decision-making and empowers community providers to communicate, collaborate, coordinate, and provide whole-person care. WISHIN can help remove health information exchange or access-related barriers and impact health outcomes at both the individual and community levels.
3. Address health equity and the social factors influencing health.
By implementing targeted interventions that address disparities in access to healthcare, education, housing, and nutrition, we can address the broader system that shapes an individual’s health. Promoting policy changes and community-based initiatives that enable all individuals to achieve optimal health outcomes regardless of social circumstances is critical.
While studying substance use mortality in Dane County, the MetaStar team uncovered a stunning disparity between African American and White residents. While deaths occurred at a rate of 26 per 100,000 among Whites, Blacks faced mortality rates at nearly four times that level (96 per 100,000). Armed with this data, MetaStar met with individuals with lived experience to understand systemic gaps while designing cohesive and comprehensive large-scale improvement strategies. MetaStar will continue to braid wisdom with those most affected to amplify their voices and identify collaborative solutions.
4. Facilitate collaborative care and comprehensive coordination.
We will focus on addressing individuals’ holistic needs by designing, implementing, and evaluating programs that seamlessly coordinate healthcare providers with other settings of support, such as community organizations. By fostering information exchange, collaborative planning, and aligned measurement, we can establish a patient-centered system to ensure care and support are not only accessible and coordinated but aligned with an individual’s preferences, meeting them where they are on their healthcare journey.
One way MetaStar is supporting this work is by partnering with Sauk County Partnership for Prevention to strengthen and expand substance use disorder/opioid use disorder prevention, treatment, and recovery services to enhance rural residents’ ability to access treatment and move toward recovery. Partners are working across the health system, public health, and community to address root causes and to face such issues head-on.
5. Better support for older adults.
With our current population trends, supporting and empowering older adults will be critical to patient safety and healthcare quality improvement. With the expansion of home and community-based services (HCBS) efforts, older adults and people with disabilities will receive necessary assistance while remaining in their homes or living in community settings. This means new ways of thinking of quality in non-traditional settings, such as assisted living facilities and home-based care.
MetaStar continues to support long-term care facilities through assessment of quality standards, support with reporting needs, and creating a continuous quality improvement culture to help identify and address safety issues proactively, creating safer and more effective care environments for aging adults in all settings.
6. Amplify feedback, communication, and transparency.
MetaStar considers this, along with oversight and accountability, to be critical to a quality health system. Transparently sharing outcomes, safety data, and quality metrics not only fosters accountability but also builds trust among care settings and patients. By creating a culture that values open communication and learning from errors, healthcare providers can proactively address challenges, implement best practices, and consistently elevate the safety and quality of care. These initiatives ultimately result in improved health outcomes and patient satisfaction.
As an External Quality Review Organization and HEDIS Licensed Organization, MetaStar actively engages with healthcare providers, payers, beneficiaries, and stakeholders to gather valuable feedback that informs health and healthcare programs. Our commitment to feedback, communication, and transparency is evident in our comprehensive reporting, auditing, and validation services. Not only do these processes identify opportunities for improvement in health and healthcare, they also provide valid and reliable data that strengthens trust and guides effective decision making.
The familiar adage, “Rome wasn’t built in a day,” rings true as we consider the development of a flawless healthcare system. Just as it took time to shape the great city, achieving a near-perfect health system will take time. Still, progress made to date has been significant and highly encouraging, the outlook for the future is even brighter, and MetaStar stands poised to play a key leadership role in guiding positive change in health and healthcare. We are excited to collaborate with you in shaping this future.