The U.S. Hispanic population aged 65 and over is projected to increase by 60 percent during the next 25 years. As this demographic ages, its health service needs will increase.
An issue facing healthcare providers is outlined by George Zeppenfeldt-Cestero, president of the Association of Hispanic Healthcare Executives. "You have a lot of people having problems with access to care due to language barriers and the ability of health organizations to respond to language and cultural issues," he says. A 2004 survey by the Kaiser Family Foundation found that three in 10 Hispanics experienced problems communicating with their healthcare providers, and two in 10 had difficulty getting care because of their race or ethnic background.
Further, according to a 2004 Census report, 32.7 percent of Hispanics don't have health insurance, compared with 15.7 percent of the total U.S. population (see table, "U.S. Population Without Health Insurance").
These numbers point to opportunities for entrepreneurs in the Hispanic health niche. "Spanish is becoming the number 2 language, so the need for service providers who speak the language and are familiar with the culture is prominent right now," says Ted Terrazas, chairman of Terra Health, a healthcare and information technology company in San Antonio.
The opportunity is especially keen for providers specializing in federal health programs.For example, Molina Healthcare, ranked number 4 on the 2005 Hispanic Business 500® with revenues of $1.1 billion, started catering to a largely Hispanic Medicare-subscribed client base.
Florida-based MEDirect Latino, a provider of Medicare-reimbursed medical products, has built its business catering to chronic diseases afflicting Hispanics. The company currently sells products to treat Type II diabetes, which MEDirect says is 1.2 times as likely to affect Hispanics as non-Hispanic whites. MEDirect estimates the current Hispanic market for its products at approximately $748 million in the continental United States, with a potential market of $1 billion, based on an approximation of Medicare-eligible Hispanics with diabetes.
Mr. Terrazas says opportunities also exist in long-term care and pharmaceuticals. "Healthcare for baby boomers and seniors is an area where businesses are migrating to, and it's a fairly big need," he says. "Another concern is pharmacy drugs – as a population gets older they need more medicine."
But as with other market opportunities, Hispanic healthcare comes with hidden perils. "Unlike other industries that use a business model to address diversity in their organizations, hospitals and the pharmaceutical industry have been slow in opening their doors," says Mr. Zeppenfeldt-Cestero. "Managed care and the pharmaceutical industry are registering record profits for their shareholders, yet Latino business owners are excluded from doing business with many in the industry."
Still, entrepreneurs know their strength lies in long-term demographics. "Healthcare is one of the few industries that – no matter what the conditions of the world – continues to grow," Mr. Terrazas says. "Hispanics are no longer just along the border it transitions into a business need. It is supply and demand."
Activists across the country are working to increase diversity at healthcare facilities and encourage better healthcare for Hispanic patients. To this end, they have produced a number of important achievements, including:
Center for Trustee Initiatives and Recruitment
A center dedicated to helping hospitals and nursing homes make their governing boards more diverse has been established.
The Center for Trustee Initiatives and Recruitment is sponsored by the Greater New York Hospital Association (GNYHA). This trade association represents 250 not-for-profit hospitals and continuing care facilities in New York, New Jersey, Connecticut, and Rhode Island. The center is designed to help healthcare providers in the Northeast and nationwide to achieve diversity in their governing bodies through:
• Recruitment. This will involve "aggressive networking and outreach" to identify a pool of talented and qualified volunteer candidates for board membership from diverse ethnic and racial groups, "including the New York metropolitan area's vast Hispanic population." The center also will connect these candidates with hospitals and nursing homes. Outreach/networking activities will involve connections with professional associations, chambers of commerce, corporations, community leaders, and advocacy groups.
• Education and Development. The center will provide a support system involving education, training, and mentoring as needed to help minority board members evolve in their roles and enhance their competency in board matters.
• Partnerships. The center actively seeks partnership arrangements with individuals and organizations committed to promoting and improving opportunities for minority representation in the management and governance of healthcare organizations.
The center's executive director is Mary Medina.
Diversity in Healthcare Leadership
A companion initiative of the GNYHA was the approval in December 2004 of an advisory task force on diversity in healthcare leadership, chaired by Ida L. Castro, currently Haywood Burns Chair for Civil Rights at the City University of New York's School of Law.
The goals of this task force, which was established in February 2005, are to help members of the GNYHA, and others, in their efforts to increase the diversity of their senior management ranks and boards of governors, and thereby enhance healthcare quality and access for minority patient populations.
The task force members, who include prominent members from diverse communities, make regular reports to the GNYHA board of governors, with a special emphasis on identifying "best practices" of individual healthcare facilities that can be described and recommended for implementation by others.
In line with this, the GNYHA has established two internship programs encouraging minority students to pursue careers in healthcare management. One of these is for undergraduate students, and the other for graduate students.
AB 1195: Cultural and Linguistic Competency
In October 2005, the National Council of La Raza (NCLR) announced passage of a bill it had sponsored requiring all continuing medical education (CME) courses for physicians providing direct patient care in California to include a component on cultural and linguistic understanding.
These CME courses, which licensed physicians are required to complete within a four-year time span, are intended to ensure that "all patients are able to communicate openly with, feel comfortable with, trust, and follow the advice of their doctors," says NCLR president and CEO Janet Murguia.
The assembly bill, AB 1195, sponsored by California Assemblyman Joe Coto (D-San Jose), follows the lead of a similar bill passed in New Jersey. It continues a trend that advocates hope will expand to other states, says Ms. Murguia.
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