Why does health equity matter at my practice?
by Michael Jones
Health equity has become a topic of increased awareness and interest in the last several years, and CMS has most assuredly taken notice. Before you think that this is not my practice, not my concern, and not something I have to worry about, it’s best to be informed of what health equity is, what CMS is doing about it, and why health equity matters at your practice.
CMS has published a broad directive titled “CMS Framework for Health Equity 2022 - 2032”, which can be found here.
This quote by Dr. LaShawn McIver, Director, CMS Office of Minority Health, which is cited in the above publication, lets you know even more the weight and scope of the dedication to health equity: “As the nation’s largest health insurer, the Centers for Medicare & Medicaid Services has a critical role to play in driving the next decade of health equity for people who are underserved. Our unwavering commitment to advancing health equity will help foster a health care system that benefits all for generations to come.”
Further, CMS has specifically defined health equity as “the attainment of the highest level of health for all people, where everyone has a fair and just opportunity to attain their optimal health regardless of race, ethnicity, disability, sexual orientation, gender identity, socioeconomic status, geography, preferred language, or other factors that affect access to care and health outcomes”.
According to CMS, health equity includes “members of racial and ethnic communities, people with disabilities, members of the lesbian, gay, bisexual, transgender, and queer (LGBTQ+) community, individuals with limited English proficiency, members of rural communities, and persons otherwise adversely affected by persistent poverty or inequality. Further, health equity also encompasses people who experience, or serve those who experience, disproportionately high burdens of disease, worse quality of care and outcomes, and barriers to accessing care. Health equity even accounts for the impacts natural disasters (e.g., earthquakes, fires, viral outbreaks) and manmade disasters (e.g., oil spills, lead poisoning, climate change) have on specific communities — both during an event and in response and recovery — as health and social risk factors may work together to cause or worsen existing health and health care disparities”.
If you thought health equity was only about racial and ethnic communities, first, know that you’re not alone, and second, realize how much more health equity is than race alone. As you can see, health equity includes a very broad reaching group, many of which you likely did not consider as being included in the overall definition of health equity. Whether your practice is in a large urban setting, suburb, rural, or anywhere in between, you will most assuredly have a subset of your patients included in one of these categories encompassing the definition of health equity.
What, then, is CMS proposing as a focus related to health equity, and how will this impact you?
CMS has clearly defined a framework for health equity priority areas, each of which will play a part in addressing the broader issue of health equity, and each of which will have a direct link to you and your practice.
Priority 1: Expand the collection, reporting, and analysis of standardized data.
Priority 2: Assess causes of disparities within CMS programs, and address inequities in policies and operations to close gaps
Priority 3: Build capacity of healthcare organizations and the workforce to reduce healthcare disparities
Priority 4: Advance language access, health literacy, and the provision of culturally tailored services
Priority 5: Increase all forms of accessibility to health care services and coverage
These five priorities include many components that will indirectly and directly impact your practice. Through standardization of data collection and reporting and analysis, CMS will be involving Medicare Advantage plans and healthcare practitioners in building out a robust feedback loop for compiling and making adjustments based on data. The Health Equity Technical Assistance Program will become more integral, through “personalized coaching and resources to help embed health equity into a strategic plan; help with data collection and analysis; and help developing a language access plan and ensuring effective communication with individuals, families and caregivers”. Broader collaboration between CMS, health plans, physician practices, and healthcare consumers will be much more prevalent.
Access to and understanding of information to the healthcare consumer will further equip patients and clinicians to work together to complete the aim of reducing disparities in healthcare among underserved communities.
In 2022, Deloitte released a report that quantifies the impact of health equity, stating that inequities currently cost the U.S. healthcare system approximately $320 billion, but, more alarmingly, without addressing healthcare disparities, this number could soar to $1 trillion or more by 2040.
What can you and your practice do about health equity right now, though?
First, make sure you and your team are listening to your patients.
A study by letsgetchecked.com showed that:
64% of respondents feel that they or their ailments are dismissed by doctors
56% of respondents disagree that “most care specialists create an environment that feels safe and comfortable”
44% of respondents with a high school degree are lower are more likely to only seek care when an urgent issue arises
This is feedback from your patients that we have some work to do with serving our patients. Furthermore, racial and sexual orientation further causes a rift between patients and their care team, which shows that more compassion and empathy is needed across all groups.
Understanding who is included when it comes to health equity and becoming aware of gaps in the delivery of care at your practice will pave the way for your success in a much more global, aware way of addressing the challenge of health equity, and we can all take pride in knowing that, as leaders, we rose to this growing dilemma.
