Johns Hopkins, IBM Offer Health Equity Metric to Reduce Disparities

August 14, 2020 - The Johns Hopkins Center for Health Equity, the Bloomberg American Health Initiative, and IBM Watson Health are partnering to develop a health equity measure that will incentivize healthcare organizations to reduce care disparities.

The organizations are seeking to identify meaningful metrics that could be included in future rankings of hospitals and health systems, such as the Fortune/IBM Watson Health Top 100 Hospitals Program.

In an article recently published in Fortune, Kyu Rhee, vice president and chief health officer at IBM; Joshua Sharfstein, director of the Bloomberg American Health Initiative; and Rachel Thornton, associate professor of pediatrics at Johns Hopkins University School of Medicine noted that the new measure could reward institutions committed to improving health equity in their own communities.

“The COVID-19 pandemic and the resulting economic crisis have shed light on the enormous disparities in health and social well-being in this country, particularly those harming communities of color, rural communities, and communities affected by poverty,” the authors wrote.

“We can begin to incentivize a commitment to community health and equity if we embed it into our evaluations of hospital performance. Many major hospital ranking systems evaluate patient satisfaction and quality of care. Few assess preventive care. None put contributions to community health and equity on equal terms with other metrics. It’s time for a change.”

The organizations’ draft proposal includes four components of a measure of community health and equity, including population-level outcomes, which will assess improvements in county-level metrics of health equity; and hospital as healthcare provider, which will evaluate whether hospitals meet best practice standards for offering preventive services. Examples of this could include violence intervention and on-site addiction treatment.

Additionally, the health equity measure will include a hospital as community partner component, which assesses whether hospitals meet best practice standards for contributing to community health initiatives.

The final component will be hospital as anchor institution, a factor that examines whether hospitals meet best practices for employers. Examples could include plans to diversify boards and management, paying a living wage, and offering childcare to all employees.

The organizations believe that these components will encourage the industry to develop innovative strategies that will promote community health and equity.

“At a time when community violence is on the rise, all hospitals provide emergency care for victims of violence; however, an inspiring group of hospitals are implementing creative programs to prevent future episodes of violence,” Rhee, Sharfstein, and Thornton stated.

“Other inventive hospitals and health systems support home visit programs, develop guidelines for healthy hospital food, educate new mothers on safe infant sleep practices, and partner with local schools to provide health services to students. We have an opportunity to recognize and socialize these innovative models in an effort to help bridge the gaps that exist in many communities. Our goal is to make these great efforts as commonplace as the hospital gift shop.”

The partnering organizations are accepting public comment until September 10, 2020. The comments will inform next steps in developing a community health and equity measure for hospitals, leading to reduced disparities and better outcomes.

“Struck by a terrible pandemic and recognizing the devastating legacy of racism, many US communities are hurting. At this pivotal moment in time, hospitals and health systems can play a critical role not just in community recovery, but also in community renewal,” Rhee, Sharfstein, and Thornton concluded.

“Recognizing and rewarding exemplary contributions to community health and equity is one place to start.”