How Equitas Health transformed its mission to deliver more comprehensive care to the LGBTQ community and those living with HIV/AIDS
By Brooke Bilyj
Equitas Health wants every patient, of any gender identity, to feel welcome. As a result, its registration forms don’t just ask for patients’ legal name and sex, but also which pronouns they prefer.
“Things like that are not common in everyday practices, but those things go a long way to ensure that patients feel like health providers understand them and their needs,” says CEO Bill Hardy. “Our providers take time to understand all aspects of an individual’s well-being, so we can deliver the most culturally competent care.”
Lesbian, gay, bisexual, transgender and queer/questioning (LGBTQ) individuals often experience health care disparities; a Kaiser Family Foundation study published in 20161 found that LGBT individuals report poorer health, more chronic conditions and higher rates of mental illness than heterosexuals. Many LGBT individuals also report negative experiences when seeking care—ranging from lack of awareness to disrespect to denial of services.
Because of these disparities and social stigmas, “a lot of LGBTQ individuals don’t ‘come out’ to their medical providers,” Hardy says, which can impact health care outcomes—especially considering that this population is predisposed to certain illnesses, sexually transmitted infections and HIV.
Equitas Health began as multiple social service organizations around the state, most of which were founded in 1984. At the time, it focused solely on HIV prevention, care and treatment. By expanding its mission to deliver more comprehensive care to the underserved LGBTQ community, Equitas Health has transformed into an inclusive health care system committed to its tagline of “care for all.”
Expanding the mission
In 2011, the organization was still known as AIDS Resource Center Ohio (ARC Ohio). The transformation began in July that year, when ARC Ohio merged with the Columbus AIDS Task Force, expanding the organization’s regional footprint and laying the foundation for growth. At the time of the merger, it was operating with about 70 employees and a budget of $6.5 million.
Then in 2012, the organization moved from social services into health care delivery for people living with HIV, through its Short North Medical Center in Columbus.
“Instead of being the middleman, we decided to provide the care that we knew patients needed and deserved, with a wrap-around model that assesses all aspects of an individual’s health care to create a one-stop shop for people living with HIV,” Hardy says.
Within six months, the Short North facility exceeded its first-year goals for patient enrollment and pharmacy revenue. When the Dayton Medical Center opened in 2014, it similarly met its first-year enrollment goals within five months.
“As we expanded, we were able to capture better health outcomes for HIV-positive patients,” Hardy says. “Our viral suppression rate – or the percentage of HIV-positive patients living with such low levels of HIV that it’s practically undetectable and untransmittable – is currently 87 percent. The national average is 49 percent2. That’s a testament to the success we’ve experienced with this model.”
Yet, the organization’s leadership realized that the nonprofit couldn’t sustain itself financially by focusing only on HIV. So it expanded again.
“We made the transition from an organization solely focused on the disease state of HIV/AIDS, to one focused on population health for the LGBTQ community,” Hardy says. “Broadening our mission helped us remain sustainable financially by diversifying our revenue streams, but it also enabled us to deliver more expansive services to address more health disparities.”
In 2016, ARC Ohio rebranded as Equitas Health, with an expanded mission to provide an inclusive health care experience to LGBTQ individuals, those affected by HIV/AIDS and other medically underserved communities.
Continuing to grow
Now with 17 locations, the Equitas health system encompasses primary care, behavioral health services, medical case management and dentistry. To support these services, Equitas also operates its pharmacies as a social enterprise.
Today, with 350 employees and a budget of $75 million, the nonprofit has grown into one of the largest community-based health care systems of its kind. Although Equitas specializes in LGBTQ health and HIV care, anyone can access its services – which are priced on a sliding fee scale, based on patient income.
This year, the organization will serve more than 67,000 patients in Ohio, West Virginia and Kentucky. And thanks to the support of its donors and community partners, Equitas Health continues to grow.
Last year, Huntington financed Equitas Health’s second Columbus location, the King-Lincoln Medical Center, located in an underserved neighborhood on the inner east side.
“Huntington is helping facilitate health care access in a community that had been dubbed ‘a health care desert,’” Hardy says. “We’re grateful for Huntington’s support of our mission so we can continue meeting the health care needs of this community.”
Sustained by social enterprise
Equitas Health is a “federally qualified health center look-alike,” which means although it’s recognized by the federal government for providing primary care services in underserved areas, it’s not eligible for federal grants. Instead, the organization relies on fundraising to support its mission. (Its biggest biennial fundraiser, Art for Life, raised more than $630,000 in 2016 and this year took place at the Columbus Museum of Art on Sept. 15, 2018.)
To help support its services, Equitas Health operates its community pharmacies as a social enterprise, so profits are reinvested into the organization. As a look-alike, Equitas Health can purchase discounted medications through the 340B Federal Drug Pricing Program, which helpsp subsidize the cost of its health center sliding fee scale.
“Our pharmacy is not only a revenue generator but also a key component of our care model,” says CEO Bill Hardy. “It supports our mission to provide care to folks who may not be able to cover the cost of our services. And since our pharmacy is open to the public, anyone can support our work just by using our pharmacy.”
For more information, visit www.equitashealth.com