Health Break: Clinical care and supportive resources for LGBTQIA+ members

Camille: Welcome to Health Break by UPMC Health Plan, your quick guide to health, wellness, and how to make the most of your health insurance plan. I’m your host, Dr. Camille Clarke-Smith. This is your…Health Break.

In this episode, Aisling McIntyre takes a Health Break to talk about the challenges members of the LGBTQIA+ community can face when getting health care. They will also outline the resources UPMC Health Plan members can access to help them navigate their health care journey with dignity and respect. Thank you so much, Aisling, for joining us on today’s “Health Break.”

Aisling: Thanks for having me.

Camille: Can you start by explaining some of the challenges that people who identify in the LGBTQIA+ community face when it comes to their health care and insurance?

Aisling: Yeah, of course. Unfortunately, a lot of LGBTQIA+ individuals often face discrimination and marginalization in their day-to-day interactions, and that can include with their health care providers. That, unfortunately, can lead to worse physical and mental health outcomes. When individuals have stressful and negative experiences during their health care encounters, a normal response is to avoid health care altogether, and that leads to worse health outcomes and puts the health and well-being of the individual at risk. Additionally, navigating insurance coverage can be difficult as insurance policies are changing, and federal and state level policies also change.

Camille: Thank you for explaining some of the challenges. I know that UPMC Health Plan has a LGBTQIA+ Affirming Provider designation in the provider directory. Could you tell us what this means and where to find it?

Aisling: So UPMC’s LGBTQIA+ Affirming Provider designation is a training-based designation that allows providers to show their commitment to providing culturally competent care to the LGBTQIA+ community members. And it also allows UPMC Health Plan members and patients to look up providers that have designated their commitment through completing the designation.

What we know is that individuals from the LGBTQIA+ community want to work with providers that have accredited training and also that have experience working with LGBTQIA+ community members. Finding providers who can treat health care-seeking LGBTQIA+ individuals with dignity and respect is extremely important for our LGBTQIA+ patients and members, and that desire is what informed UPMC Health Plan’s decision to create the LGBTQIA+ Affirming Provider designation. The designation is accredited, opt-in, and training based. Providers who are committed to creating safe and welcoming patient-provider relationships with their LGBTQIA+ patients can complete the designation process. And to earn the designation, providers complete training modules that were developed with the National LGBTQIA+ Health Education Center and also informed by LGBTQIA+ focus groups that happened here in Pittsburgh as well as by others who are committed to health equity at UPMC Health Plan.

Having providers’ designations viewable in UPMC’s provider directory allows LGBTQIA+ patients and members to identify providers who can validate their experiences and are committed to providing affirming culturally competent care. You can find an LGBTQIA+ Affirming Provider at findcare.upmchealthplan.com, by selecting the LGBTQIA+ affirming filter. Or you can look for the affirming provider icon, which is a little rainbow flag.

Camille: Thank you. Can you share what are some of the other resources UPMC Health Plan offers to the LGBTQIA+ members?

Aisling: Yeah. UPMC has a lot of resources available to our LGBTQIA+ members. I would love to call out my top favorite three.

In 2017, UPMC established the LGBTQIA+ Health Care Concierge line to support our transgender and gender diverse members in navigating their benefits and health care coverage. The concierge line is run by UPMC Health Plan’s LGBTQIA+ Task Force, and it’s staffed by exceptional and really passionate Member Services staff. This service is one of the first insurer-led support services for transgender and gender diverse members across the nation. Concierge line staff assist members with finding in-network providers when possible, navigating insurance benefits, copays and the reimbursement process, and they also assist members with filing complaints, grievances, and appeals if that’s ever needed. Calls are answered by the Member Services team who assesses the member’s history and their procedure goals. They provide them with care management activities that can help them to meet those procedure goals, and they also help with policy navigation as well.

In 2023 alone, over 1,000 phone calls were received through the LGBTQIA+ concierge line, which I think really speaks to the value of that service as well as the need that’s present within our member community.

As mentioned earlier, unfortunately, some members do experience stigma and discrimination when they see a health care provider and UPMC Health Plan is committed to addressing those experiences as quickly as possible. UPMC Health Plan has a complaint line that any member can call in for any reason, but the Health Plan specifically set up a process to review complaints from our LGBTQIA+ members as quickly as possible to ensure that we’re addressing any negative experiences.

And the last thing I would love to call out is our Member Preference Center. Our Member Preference Center allows members the option to self-identify as part of the LGBTQIA+ community by sharing their sexual orientation and/or gender identity. Capturing sexual orientation and gender identity data, also known as SOGI data, is a critical step in advancing population health equity. SOGI data allows us as a health plan to measure and act upon health disparities in the LGBTQIA+ community. And also more importantly, it helps our members feel validated and welcome when they meet their providers because they know their providers are going to meet them where they’re at.

Camille: Thank you so much, Aisling, for taking a Health Break with us and talking to us about the challenges that members of the LGBTQIA+ community face when getting health care. Hope you join us again.

Aisling: Thanks again for having me.

Camille: Check the show notes for links and more information about all of these resources for LGBTQIA+ UPMC Health Plan members.

Find show notes and more information at upmchealthplan.com/podcast. Join us as we continue exploring health, wellness, and how to make the most of your health insurance plan in the next episode of Health Break.

This podcast is for informational and educational purposes. It is not medical care or advice. Individuals in need of medical care should consult their care provider. Views and opinions expressed by the hosts and guests are solely their own and do not necessarily reflect those of UPMC Health Plan and its employees.