Author: Karin VanZant, Vice President, Social Determinants of Health & Health Equity
In today’s ever-evolving healthcare landscape, two words are resonating across national offices and cannot be ignored – Health Equity (HE). The significance of health equity is intensifying, with organizations like CMS, NCQA, and NAMD zeroing in on its importance. If you’re involved in healthcare, delving deep into the world of health equity is essential.
The Framework for Health Equity
When you search “CMS health equity” on Google, the first result is its Framework for Health Communities, a program developed in 2022 that sets five priorities for how the Agency will direct its efforts to address health disparities and close gaps in health outcomes.1
These priorities include:
- Expanding the collection, reporting, and analysis of standardized data
- Assessing opportunities to close gaps in CMS programs, policies, and operations
- Building the capacity of health care organizations and the workforce
- Promoting language access, health literacy, and the provision of person-centered services
- Increasing access to health care services for individuals living with a disability
The CMS framework encourages the entire healthcare ecosystem to focus on these priorities in the coming years. As the federal level emphasizes equity, accountability, and access, there is hope for a perceived impact at the individual member level.
State-Level Initiatives
The National Association of Medicaid Directors (NAMD) has been at the forefront of promoting health equity at the state level. It continues to play a pivotal role in driving initiatives that address health disparities and advance equitable healthcare access. Their ongoing efforts include:
- Medicaid & Housing: Establishing Contexts for Successful Care Access2
- What Does Authentic Medicaid Member Engagement Look Like?3
As a social worker and community developer, I deeply appreciate these efforts. Stakeholders at all levels should strive to be committed to health equity and by extension connecting directly with the individuals they support and serve. No survey or dataset can replace direct interaction with individuals who have lived experience. NAMD’s emphasis on authentic Medicaid engagement gives hope for a newfound appreciation that members, patients, clients, and consumers—regardless of the label used—are vital to the success of any healthcare organization.
To provide effective care, it takes time, strategy, and energy to sufficiently support them. Listening, getting to know them, and understanding their needs are key to delivering on the promise of care. However, it is challenging to foster these connections when there is an inherent lack of trust in the healthcare system and a shortage of trusted advisors or navigators bridging the gap. These disconnects contribute to some of the most significant health disparities we face.
The Next Wave of Health Equity Requirements
Health equity is rapidly moving from a compliance mandate to a competitive advantage. Over the next few years, organizations can expect equity-related measures to be embedded into nearly every aspect of healthcare policy and contracting. CMS has already signaled its commitment through new equity-focused reporting requirements, and it’s likely that state Medicaid agencies and commercial payers will follow.
Health plans should anticipate:
- Expanded stratification of quality measures by race, ethnicity, language, and other demographics, making equity a visible part of performance reporting.
- Equity-related requirements in Medicaid and Medicare contracts, with financial penalties or incentives tied directly to reducing disparities.
- Stronger expectations for community partnerships, where payers must demonstrate active collaboration with local organizations to address social needs like housing, food security, and transportation.
By preparing for these shifts now, health plans can build internal capacity and position themselves as leaders, not followers, in advancing health equity. Those that view equity as a driver of both quality improvement and competitive differentiation will be better equipped to thrive in a future where equitable care is non-negotiable.
Transition to Health Equity Accreditation
The National Committee for Quality Assurance (NCQA) accreditation process underwent significant changes in 2022, particularly regarding Health Equity Accreditation. The transition from Multicultural Distinction to Health Equity Accreditation, along with new state HE Accreditation requirements, has prompted plans to add this to their to-do lists.
For many organizations, accreditation is often seen as a compliance hurdle. But NCQA’s Health Equity Accreditation is more than a checklist. It’s a public declaration that your organization takes equity seriously. Several states have already embedded accreditation into Medicaid requirements, and more will follow. Plans that pursue accreditation now are not only checking a regulatory box but also signaling to members, regulators, and partners that equity is part of their DNA.
In other words, accreditation is the floor, not the ceiling. It establishes the foundation, but what organizations build on top of it whether in workforce training, member engagement, or community partnerships determines how meaningful their equity initiatives truly are.
Real change happens when organizations move beyond compliance and apply equity principles in daily operations. Across the country, forward-looking organizations are already experimenting with new models:
- Medicaid plans collaborating with housing authorities to secure stable living conditions for members at risk of homelessness, reducing avoidable readmissions.
- Hospitals investing in community navigator programs to rebuild trust and guide underserved patients through complex care systems.
- Health systems tying equity goals to workforce development, ensuring clinical leadership reflects the diversity of the populations they serve.
These examples show that the true promise of health equity lies in meaningful action, not just meeting accreditation standards. By embedding equity into clinical operations, community engagement, and leadership accountability, organizations can improve outcomes, lower costs, and rebuild trust in the healthcare system. Accreditation is the foundation, but it is the ongoing commitment to action that creates lasting impact.
The Holistic Approach to Health Equity
Health equity is not an isolated concept; it should be ingrained into a health plan’s culture, operations, and care management infrastructure. Over time, integrating a health equity strategy with care coordination, quality improvement, member service, and population health management can enhance member engagement, bridge gaps in care, and reduce risks and costs.
This holistic integration goes beyond compliance and strengthens value-based care contracts, supports population health initiatives, and rebuilds patient trust. True equity requires leadership accountability, sustainable community partnerships, and a willingness to invest in long-term change.
Clearlink, a strategy-through-execution consulting organization, specializes in helping organizations achieve regulatory compliance and accreditation. By partnering with our experts, your organization will be equipped with the necessary tools to make significant strides in delivering high-quality, equitable services to your members.
As federal and state-level requirements continue to exert pressure on healthcare organizations, combining health equity services with your existing infrastructure becomes crucial. At Clearlink, we tackle these challenges daily for health plans. If you need assistance in preparing for ongoing compliance and optimizing health equity services, you’ve come to the right place. Contact us today.
Sources:
1. CMS Framework for Healthy Communities, CMS
2. Medicaid & Housing: Establishing Contexts for Successful Care Access, NAMD
3. What Does Authentic Medicaid Member Engagement Look Like, NAMD