Social Entrepreneurs Are Reimagining American Healthcare
By Lawrence Leisure
April 29, 2021
When Abner Mason explains why the American healthcare system is failing, he doesn’t begin by discussing providers or payers or pharmaceutical prices. Instead, he talks about Netflix.
“Netflix isn’t going to recommend the same set of films to two different people,” he pointed out during our conversation. “Its platform is designed to treat subscribers as unique people. It curates recommendations based on a user’s cultural experiences, language, taste preferences — in other words, who they are personally. People have come to expect that quality of service.”
But in healthcare, he says, that level of awareness is often sorely lacking.
“Right now, we’re seeing a lot of what I call a 1.0 model of engagement, which is all about English speakers,” Mason explained. “You have one message drafted for native English speakers. Then, that message is translated — often poorly — into a dozen languages without any recognition of different cultural perspectives on healthcare.
“But when you superimpose an approach designed for predominantly white English-speakers onto everyone else, you’re essentially treating people as if their cultural experience, social determinants of health, and unique health needs don’t matter. That you don’t care enough to build trust or find culturally-attuned ways to connect them to the care they need.”
“It’s a kind of erasure,” he concluded.
This trend is problematic on its own. But it is even more so given that the U.S. is on-track to become a minority-majority country by 2045. Some states, such as California and Texas, have already attained the distinction. The American health system is approaching modern healthcare with an outdated playbook that doesn’t take the country’s growing multiculturalism into account; care gaps in those overlooked, under-engaged communities are inevitable.
This is where Mason’s company, Consejo Sano (“Sound Advice”), comes into play. Consejo Sano works with health plans and provider groups to close gaps in care by building trust and explaining care value in a culturally- and linguistically-sensitive way.
“Think of a new mom,” Mason offered as an example. “She’s first-generation immigrant who doesn’t speak English and distrusts the medical system. Her health plan wants to make sure her baby gets his vaccinations on-time, because it’s evaluated based on the proportion of members who receive certain necessary care procedures. We’ll reach out to that mom, engage with her about her baby’s care, and explain why he needs those vaccinations in thoughtful, culturally-sensitive way.”
Given the social focus of Consejo Sano’s mission — to increase multicultural awareness in healthcare — a layperson might assume the organization was a nonprofit. But Mason founded Consejo Sano as a for-profit organization specifically because he felt it could do more good, more consistently, in the long term.
Nonprofits, he explained, have their drawbacks.
“You’re always looking for funding,” he said, referencing his past experience as a nonprofit founder. “Always. It’s hard, because funders’ interests change so quickly. Since you’re constantly chasing grants and fickle investors, you’re not really in a position to focus on building long-term solutions like you would be in a for-profit.
“When you’re in a nonprofit, you don’t really know whether the solutions you’re providing are sustainable, because you don’t need to know. Contrast that to a for-profit, where you constantly need to innovate to stay ahead of competitors. The model makes you laser-focused on creating solutions that add and create value,” Mason explained.
Applying a For-Profit Approach to Bolstering Healthcare in Underserved Communities
Margaret Laws, the president and CEO of HopeLab, a philanthropic research, design, and technology organization focused on improving the mental health and wellbeing of young people, concurs with Mason’s perspective.
“The point you have to remember is that if the company isn’t sustainable, it isn’t going to serve anyone,” she told me.
HopeLab, like Consejo Sano, is a for-profit organization that aims to improve healthcare in America. And, as Laws explained during our conversation, achieving that goal often demands a bit of a balancing act.
“The goal is to make two pieces work together,” Laws said. “On the one hand, I’m trying to push the market to focus on progressive products. On the other, I’m encouraging the lab to create solutions that match current market demands. The innovation side is creating new products for the market; the market side helps the innovators understand what payers are ready to buy or promote.”
Laws pointed to Nod, HopeLab’s most recent development project, as an example of how this balance works in practice.
“We started Nod because we knew there was a big problem with anxiety, depression, and suicide on college campuses, which has a lot to do with pervasive loneliness,” she explained. “So, the lab began creating a product that would use psychology and neuroscience tenets to help college students manage their loneliness.
“Now we’re selling Nod to colleges and universities. We’re even finding ways to adapt the product for K-12 students, because clients in that space have commented that their students could benefit from something like Nod, too.”
But, as with Consejo Sano, Hope Lab has found that building a successful and sustainable business in the healthcare sector requires a degree of tailoring.
“There’s a real focus on co-creation in everything we do,” Laws explained. “When we develop products, our researchers are working directly with the young people we’re looking to support. We need to understand how they’re seeing the world, what drives them into certain behaviors, what they need to transition into a higher level of health.” At Hope Lab, young people play a role in every stage of product development, from conception to construction and testing.
“Young people will help us figure out the form of the product — whether it should be an app, a game, a group activity — and help us draw storyboards,” Laws explained. “They tell us what they like and don’t like. It’s only with their help that we can create solutions that are resonant, effective, and specific to their needs.”
Private Sector Organizations Have Begun to Recognize the Need for Tailored Products
In my conversations with both Mason and Laws, one throughline emerged: the private sector wants tailored healthcare products for underserved populations.
“Sometimes it can take some time to figure out which payer would be the best fit for a product — you know, whether it’s traditional healthcare, philanthropic organization, universities, so on. But the need is there,” Laws shared.
If anything, demand for socially-aware, culturally-sensitive healthcare products has only grown amid America’s increasing diversification and recent civil rights movements.
Colin Quinn, co-founder and CEO of the LGBTQ+ healthcare platform Included Health, points to the Black Lives Matter movement as a pivot-point for inclusive healthcare.
“When Black Lives Matter began sparking conversations, companies found themselves having difficult discussions about how they were supporting their Black employees — and as they did, they started thinking about what they could do to support other minority groups,” Quinn explained in an interview.
“Now, more than ever, people are looking for tailored solutions that cater to their unique health needs rather than accepting this current one-size fits all approach,” he continued. “People are actively seeking out doctors and providers who are not only clinically competent, but also culturally competent in the way they interact and provide care.
“Included Health members are overwhelmingly seeking out providers who look and identify like them, meaning they are selecting providers based on characteristics like sexual orientation, gender, race and ethnicity. Now more than ever, payers are beginning to realize how much that identification matters.”
From all of this, one point becomes clear — nonprofits aren’t the only (or even the most influential) organizations reshaping the American healthcare system for the better. Private sector consumers are well-aware of the value tailored, sensitive healthcare experiences hold in America’s increasingly diverse communities. For-profit business that can strike a balance between social benefit and sustainable business by creating socially-sensitive and market-aware healthcare solutions stand to spark long-lasting, positive change in the sector.
To borrow a final quote from Hope Lab’s Margaret Laws — “It really is a wonderful, interesting puzzle, figuring out how to bring genuinely helpful solutions to market.”