CMS is the largest provider of health insurance in the United States. CMS is responsible for more than 170 million individuals supported by CMS programs and it announced its priority of health equity. The CMS Office of Minority Health released the CMS Framework for Health Equity to address health disparities. CMS will use its framework to design, implement, and operationalize policies and programs. These priorities will inform CMS’s efforts for the next ten years.
“Our unwavering commitment to advancing health equity will help foster a health care system that benefits all for generations to come.”
- Dr. LaShawn McIver, Director, CMS Office of Minority Health
What is Health Equity? CMS defines 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.
Supporting Underserved Communities. The framework comes from Executive Order 13985 on Advancing Racial Equity and Support for Underserved Communities Through the Federal Government. The term “underserved communities” is defined as populations sharing a particular characteristic, including geographic communities that have been systematically denied a full opportunity to participate in aspects of economic, social, and civic life, as exemplified in the definition of “equity.” This 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.
How Does this Work? The idea is to support health for all people served by CMS programs by
- eliminating avoidable differences in health outcomes experienced by people who are disadvantaged or underserved, and
- providing the care and support that our enrollees need to thrive.
The idea is also to make lasting change in the healthcare system and in people’s lives. It builds on the work of The CMS Equity Plan for Improving Quality in Medicare. The new areas of focus include reduction of disparities and promotion of sustainable actions to achieve health equity. Here are the five priorities:
- 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 health and healthcare disparities
- Priority 4: Advance language access, health literacy, and the provision of culturally tailored services
- Priority 5: Increase all forms of accessibility to healthcare services and coverage
What’s Next. These five priorities provide an integrated approach to build health equity into existing and new efforts by CMS and our stakeholders. As CMS tracks and builds out these priorities, additional focus on access laws and new guidance could come. Measuring of data means the ability to track quality and demographics, which in the future could create opportunities for better patient outcomes and ideas related to payment reform. At this same time, health equity should become a governance, patient safety, employment, and compliance priority for hospitals, physicians, healthcare providers, insurers, employers, and others supporting communities and their health.