- Reducing socioeconomic health disparities and encouraging providers to leverage population health management and data analytics in pursuit of better patient outcomes are two of the major goals of CMS’ ongoing Equity Plan for Improving Quality in Medicare, says Cara V. James, PhD, Director of the Office of Minority Health, in a CMS blog post.
The plan, released one year ago in conjunction with Medicare’s 50th birthday celebrations, highlights the importance of developing data collection, reporting, and analytics capabilities to serve as the foundation for a broad population health management plan that can ensure equal access to high-quality care for Medicare patients from all walks of life.
“The foundation of the CMS Equity Plan for Improving Quality in Medicare, is our 3-part ‘path to equity’ framework,” James explains.
“The path involves: (1) increasing understanding and awareness of disparities, (2) developing and disseminating solutions, and (3) taking sustainable action and evaluating progress.”
The framework is designed to meet healthcare stakeholders wherever they are on the journey towards equity, she continues, and provides a roadmap for entities across the care continuum, including individuals, local and state organizations, and policymakers.
After a year-long collaboration with stakeholders, CMS has identified six major areas of opportunity to focus the health systems’ efforts:
• Broaden the collection, reporting, and analysis of standardized data to develop a complete and accurate view of the healthcare disparities landscape
• Evaluate the impact of disparities and deploy equity solutions across the CMS ecosystem
• Develop new and promising strategies to address disparities and share best practices throughout the health system
• Give healthcare workers the tools and resources required to meet the clinical and socioeconomic needs of vulnerable patient populations
• Ensure that patients with limited English proficiency and persons with disabilities are able to communicate their needs and develop strong relationships with healthcare workers
• Improve the physical accessibility of healthcare facilities to ensure that patients can comfortably and consistently access care
This strategic approach is in line with overall CMS goals to improve care quality, reduce costs, and deliver a meaningful patient experience, the framework states, while also strengthening the health system’s ability to leverage data analytics for overall quality improvements.
James notes that since the launch of the plan last year, CMS has 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.”
The Office of Minority Health has also released a free, online data visualization tool called Mapping Medicare Disparities that gives stakeholders a detailed look at health disparities on a local, state, and national level.
The tool reveals surprising differences in the costs of care and the outcomes of certain chronic diseases, including heart failure and diabetes, and while this information is valuable to providers and policymakers, the data is not as complete and detailed as it needs to be in order to continue to make progress.
“Part of the challenge is that we don’t always have data on race and ethnicity for some of our beneficiaries. It’s a voluntary reporting field, of course, so there are often gaps in that data,” said James in an interview with HealthITAnalytics.com earlier this year.
“We aren’t able to report for all the populations because of the small size of the data for some of those groups. It’s the best we’re able to do at this time, but it does produce an incomplete picture.”
The Equity Plan aims to close these gaps by educating healthcare stakeholders about the importance of collecting as much standardized data as possible, including information on race, ethnicity, language proficiency, and disability status.
“Developments in health information technology have significantly increased the feasibility of measuring disparities at the provider level as well as the capacity to do so,” the framework states.
“Further, the need for complete and accurate demographic data is being promoted widely within the provider community, encouraged by federal programs and policies (e.g. the HHS Disparities Action Plan and the Overarching Secretarial Priorities) and through meaningful use incentives.”
The Merit-Based Incentive Payment System also provides organizations with the impetus to address the social determinates of health by making health equity one of the areas of clinical practice improvement activities, James added.
CMS intends to ramp up its efforts to share best practices and actionable methodologies for collecting this data from patients so that policymakers can better allocate resources and target education to high-needs areas.
“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,” James concluded. “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.”