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
Let’s begin with CMS. When you search “CMS health equity” on Google, the first result is its Framework for Health Equity. This framework is dedicated to five priorities aimed at reducing health disparities and will guide the agency’s efforts for the next decade. 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
The CMS framework ensures that the healthcare pipeline will focus on these priorities in the coming years. They are essential elements of our healthcare ecosystem. As the federal level emphasizes equity, accountability, and access, there is hope for a perceived impact at the individual member-level. On April 5, 2023, CMS released the 2024 Medicare Advantage and Part D Final Rule, highlighting requirements that aim to improve health outcomes, expand coverage, and advance health equity.
The National Association of Medicaid Directors (NAMD) has been at the forefront of promoting health equity at the state level. As we progress through 2023, NAMD 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 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 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.
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 the rest of this year and 2024. Here are a few essential points to know:
- Eleven states have already incorporated HE Accreditation into their Medicaid plan requirements, with more expected to follow.
- There are six standards with 21 elements, including new ones that were not part of the Multicultural Distinction process.
- Health plans that have already obtained the Multicultural Distinction have multiple pathways to transition into HE Accreditation. However, plans without the Multicultural Distinction must undergo the full survey process.
- Some of the elements require look-back periods of 24 months.
- It’s not mandatory for plans to have completed NCQA Health Plan Accreditation to pursue HE accreditation.
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. 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!