Working to Achieve Health Equity: The CMS Equity Plan for Medicare One Year Later
By: Cara V. James, Ph.D., Director of the Office of Minority Health at the Centers for Medicare & Medicaid Services
One year ago, the Centers for Medicare & Medicaid Services (CMS) launched its first ever Equity Plan for Improving Quality in Medicare at a conference commemorating the 50th anniversary of Medicare and Medicaid and the 30th anniversary of the Report of the Secretary’s Task Force on Black and Minority Health. The CMS Equity Plan for Improving Quality in Medicare is an action-oriented plan that focuses on six priority areas and aims to reduce health disparities among vulnerable populations including, racial and ethnic minorities, sexual and gender minorities, and people with disabilities.
The foundation of the CMS Equity Plan for Improving Quality in Medicare, is our 3-part ‘path to equity’ framework. The path involves: (1) increasing understanding and awareness of disparities, (2) developing and disseminating solutions, and (3) taking sustainable action and evaluating progress. Our path to equity enables us to take a comprehensive approach to addressing health disparities because it promotes progress regardless of where stakeholders are in their efforts to achieve health equity. In addition, the path to equity can be adopted by a wide range of stakeholders and organizations and applied from the individual level up to the community, state, and policy levels. The priorities and activities described in the Equity Plan for Medicare were developed during a rigorous year-long process, which included examining evidence, identifying opportunities, and gathering input from a broad array of stakeholders across the country. The plan includes six priority areas and an array of activities. They are:
Priority 1: Expand the Collection, Reporting, and Analysis of Standardized Data
Priority 2: Evaluate Disparities Impacts and Integrate Equity Solutions across CMS Programs
Priority 3: Develop and Disseminate Promising Approaches to Reduce Health Disparities
Priority 4: Increase the Ability of the Health Care Workforce to Meet the Needs of Vulnerable Populations
Priority 5: Improve Communication and Language Access for Individuals with Limited English Proficiency and Persons with Disabilities
Priority 6: Increase Physical Accessibility of Health Care Facilities
Since the launch of the CMS Equity Plan for Improving Quality in Medicare, we have been actively working to increase our understanding of disparities among Medicare beneficiaries with limited English proficiency and disabilities, and our knowledge of how to better prepare our workforce to meet the needs of vulnerable populations. To assist stakeholders in identifying disparities at a local, state, or regional level, we launched our Mapping Medicare Disparities Tool earlier this year. The Mapping Medicare Disparities Tool is an interactive map, which can be used to identify areas of disparities between subgroups of Medicare beneficiaries in health outcomes, utilization, and spending. To assist in the identification of disparities within Medicare health plans, we released for the first time national and contract level quality data stratified by race and ethnicity.
We have been working to develop solutions to help spur sustainable action. As part of our Building an Organizational Response to Health Disparities portfolio, we released the Guide to Preventing Readmissions among Racially and Ethnically Diverse Medicare Beneficiaries. This guide gives an overview of key issues related to readmissions for racially and ethnically diverse Medicare beneficiaries, as well as useful resources for hospital leaders to take action to address readmission. Our guide offers case examples of strategies and initiatives. We also released a compendium of resources for standardized demographic and language data collection to help organizations collect and analyze their own data, so that they may begin to increase understanding and awareness of disparities that may exist within their own organization.
To ensure that actions around equity at CMS are sustainable, we have been working with our colleagues across the Agency to identify where equity can be embedded. To that end, reducing disparities, focusing on social determinants of health, and advancing health equity have been called out in a number of models and initiatives. Within the Merit‐Based Incentive Payment System (MIPS), achieving health equity is one of the areas for clinical practice improvement activities. At the heart of the Accountable Health Communities Model is identifying and addressing the health-related social needs of beneficiaries.
While we have reached a number of milestones this year, we know that there is still much work to be done to achieve health equity. As we continue implementing the CMS Equity Plan for Medicare, we will focus on building on our accomplishments, strengthening our partnerships, and monitoring and evaluating our progress. We cannot do this work alone, so we encourage you to join us on the path to equity. By working together, we can truly achieve care and services that are high quality, effective, and equitable.
To learn more about our accomplishments regarding achieving health equity in Medicare and other activities underway at the CMS Office of Minority Health, visit: go.cms.gov/omh.