Author: Karin VanZant, Vice President, Social Determinants of Health & Health Equity
As we enter the new year, two words are buzzing around the national offices that cannot be ignored – Health Equity (HE). Everywhere you look, HE is coming on strong. CMS, NCQA, NAMD, you name it, are all zeroing in on it. If you are in healthcare and are not deep into the world of health equity, you need to pay attention.
Let’s start with CMS – the first thing that pops up in a google search of “CMS health equity” is its newly released Framework for Health Equity, posted November 10, 2022. The framework is focused on five priorities for reducing disparities in health and will inform the Agency’s efforts for the next ten years. These priorities include:
- Expanding the collection, reporting and analysis of standardized data
- Assessing causes of disparities within CMS programs and address inequities in policies and operations to close gaps
- Building capacity of health care organizations and the workforce to reduce health and health care disparities
- Advancing language access, health literacy and the provision of culturally tailored services
- Increasing all forms of accessibility to health care services and coverage
You can be sure this framework means that everyone in the healthcare pipeline will focus on these priorities in the coming years. They are essential in our healthcare ecosystem. As we witness an increased emphasis on equity, accountability, and access at the federal level, we hope it will make a perceived impact at the individual member-level. In addition, on December 14, 2022, CMS released the Contract Year 2024 Policy and Technical Changes to the Medicare Advantage and Medicare Prescription Drug Benefit Programs Proposed Rule (CMS-4201-P). Several proposed changes highlight CMS’s focus on the strategic pillars to improve health outcomes, expand coverage and advance health equity. CMS accepts comments on the proposed changes until February 13, 2023.
“In partnership with CMS, states have been working hard to better meet the health-related social needs of people with Medicaid coverage,” CMS Administrator Chiquita Brooks-LaSure said in a press release on January 4, 2023. “Today’s announcement is the next step in CMS’ effort to use every lever available to protect and expand coverage for all eligible individuals as we work with our state partners to offer whole-person care.”
At a state level, the National Association of Medicaid Directors’ communications, following the Fall 2022 Conference in November, have focused heavily on promoting Health Equity. The organization published three blogs on the subject in December alone:
- Medicaid & Housing: Establishing Contexts for Successful Care Access
- What Does Authentic Medicaid Member Engagement Look Like?
- Tips and Concepts for Putting Equity as the Center of Strategy and Communications
As a social worker and community developer, I appreciate this effort. Stakeholders at all levels should strive to connect directly with the individuals they support and serve. No survey or data set can replace direct interaction with a person with lived experience. NAMD’s emphasis on Authentic Medicaid Engagement gives me hope for new appreciation that members, patients, clients, and consumers – whatever you call the individuals you are serving, are vital to your business. It takes time, strategy, and energy to support them sufficiently. Listening to them, getting to know them, and understanding what they seek are key to delivering on the promise of care. Yet, it is hard to connect when there is an inherent lack of trust in the healthcare system as well as a lack of trusted advisors or navigators to bring the two entities together. – We see the disconnect contribute to some of the biggest issues with health disparities.
We know that 2022 brought many changes to the National Committee for Quality Assurance (NCQA) accreditation process, especially the process for Health Equity Accreditation. The transition from Multicultural Distinction to Health Equity Accreditation, followed by new state HE Accreditation requirements, has plans adding this to their to-do lists in 2023-2024.
Here are a few things you need to know:
- Eleven states have added HE Accreditation to their requirements for Medicaid plans, and NCQA anticipates more to follow.
- There are six standards with 21 Elements. Of these, several are new and were not part of the Multicultural Distinction process.
- There are multiple pathways for health plans that have already obtained the Multicultural Distinction to transition into HE Accreditation. Plans that do not have the Multicultural Distinction, however, must follow the full survey process in place. Note that some of the Elements require look-back periods of 24 months as well.
- Plans do not have to have completed NCQA Health Plan Accreditation to become HE-accredited.
Health Equity is not something that happens in isolation. Health Equity is ingrained into a health plan’s culture, operations, and care management infrastructure. Over time, the Health Equity strategy combined with care coordination, quality, member service, and population health management can increase member engagement, close gaps in care and reduce risks and costs. Working with a strategy-through-execution consulting organization like Clearlink is a reliable way to accomplish this aim and prepare for federal and state-level requirements, whether present or future. By partnering with our experts, your organization will be equipped with the tools to make great strides in delivering high-quality, equitable services for its members.
Need help preparing for ongoing pressure to comply with federal and state requirements and combine health equity services with your organization’s existing infrastructure? You’re in the right place. At Clearlink, we do this daily for health plans. Contact us today!