Addressing Inequities: Promoting Health Insurance Accessibility In Underserved European Communities – Health equity remains an important challenge in societies around the world. Factors such as socio-economic status and limited access to resources create disparities in health outcomes. Through technology, we increase access, promote equitable care, and empower individuals to take control of their well-being. Join us as we explore the transformative potential of healthcare digitization in bridging gaps and addressing health inequities.
Digitalization of healthcare can remove barriers related to geographic distance, allowing people in remote or underserved areas to access quality care. Telemedicine, for example, allows patients to connect with health professionals virtually, breaking down geographical boundaries. This virtual interaction reduces the need for travel and opens the door to medical consultation, follow-up, and monitoring regardless of location. Through telemedicine, individuals can seek timely care, leading to early detection of diseases and improved health outcomes.
Addressing Inequities: Promoting Health Insurance Accessibility In Underserved European Communities
Digital health platforms empower individuals to actively participate in their healthcare journey. Patient portals, mobile apps, and wearable devices provide access to personal health records, educational resources, and self-management tools. Digitalization of healthcare empowers patients with information and tools, promoting health literacy and active participation in their care. It fosters better decision-making, early intervention, and improved management of chronic conditions, reducing health disparities.
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Digital solutions enable healthcare providers to identify and address specific health disparities by tailoring interventions to specific populations. Data analytics and population health management tools can help identify at-risk communities and design targeted interventions to address their unique healthcare needs. By leveraging insights from digital health records, healthcare systems can implement preventive measures, health promotion campaigns, and disease management programs to tackle disparities related to chronic conditions, mental health, and more.
Digitalization of healthcare promotes the delivery of standardized and evidence-based care, ensuring consistency in treatment approaches. Electronic health records (EHRs) streamline the sharing of patient information among healthcare providers, reducing the likelihood of errors and fragmented care. This cohesive approach enables healthcare professionals to collaborate, coordinate, and deliver comprehensive care regardless of patient background or location. Standardized care pathways and decision support systems built into the platform also reduce implicit bias, promoting equitable healthcare delivery.
Digitalization of healthcare offers great potential for health education and preventive interventions. Mobile apps, online platforms, and social media campaigns can disseminate accurate health information, empowering individuals with knowledge about preventative measures, healthy lifestyles, and early warning signs. By targeting underserved communities and vulnerable populations, digital health initiatives can bridge information gaps, promote health equity, and enable individuals to make informed choices about their well-being.
Healthcare digitalization holds tremendous promise in addressing health disparities, increasing access, empowering patients, and leveraging targeted interventions. Standardization of care and health education also contribute to equitable outcomes. Embracing digitization requires inclusivity, accessibility, and privacy to ensure improved health for all.
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There are two types of quality measures: those that are regulatory-driven – required or incentivized by the Federal government – and recommended measures from organizations and programs, including federal departments and other non-profits, think tanks and research institutions.
As a follow-up to article one on the recent health equity regulations, this article provides an overview of the main health equity frameworks and measures that shape how health equity performance will be implemented and measured.
At this time, there is no national standard method for obtaining data on health equity variables. In addition, there is no standard measure to evaluate the results of improving health equity. To create accountability and transparency, both are important.
Quality Over Quantity
Research to identify health equity measures, best practices, and strategies finds limited resources. However, new health equity activities and initiatives have increased as frameworks, payment models, and accreditation requirements are released from organizations such as NCQA, CMS, RWJF and others.
The definition used from the US Office of the Assistant Secretary for Planning and Evaluation and the RAND Corporation, published by the National Committee for Quality Assurance (NCQA) provides the foundation:
“A definition of ‘measure of health equity’ has been proposed to build consistency in the discussion and application: an approach to reflect or summarize the extent to which the quality of health care provided by an organization contributes to reducing disparities in health and health care at the population level for patients who have a burden of factors greater social risk by improving patient care and health.
And, because equity and quality measures are intrinsically connected, it is wise to look to quality organizations for accreditation, frameworks, and recommendations for health equity measures.
Comparing Major Health Equity Frameworks & Measures
Even before the Institute of Medicine (IOM) published “Unequal Treatment” in 2003, the organization had conducted research, polled the industry, and published recommendations on how to approach health equity data, collect, analyze, and measure it.
Recent social events and policy changes are moving health equity measures from ideas to frameworks to requirements. Although there are many health equity models and working groups, we have selected the most prominent health equity frameworks, indicating that they have measurement requirements as part of payment arrangements or alternative accreditation.
See Figure 1 for a health equity framework matrix that covers all of the following. Download a PDF of the matrix here for easy viewing.
Launched on July 1, 2023, this advanced certification program recognizes hospitals and critical access hospitals that strive for excellence in providing equitable care, treatment, and services. At the beginning of 2023, pre-publication requirements are distributed to emphasize the structures and processes that organizations must have in place to support equity and reduce health disparities.
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Two new accreditation programs replace the distinction for Multicultural that the National Committee for Quality Assurance (NCQA). NCQA’s Health Equity accreditation includes updated standards around health equity and linguistically appropriate services.
NCQA Health Equity Accreditation Plus is for organizations with more mature health equity initiatives. In the publication, there are 114 organizations that have received health equity accreditation and seven that have been accredited for the Plus program.
This accreditation designation is much more than a health plan. Many organizations are eligible for this accreditation: health plans, health systems, hospitals, managed behavior organizations, population health organizations, fitness organizations, and others.
The Centers for Medicare & Medicaid Services (CMS) redesigned the Global and Professional Direct Contracting Model (GPDC) Model to rename it the ACO Realizing Equity, Access, and Community Health (REACH) Model. Focused on Medicare beneficiaries, ACO REACH is reportedly a temporary model that will expire in 2026 and is expected to serve up to three million patients. As of August 2022, 110 ACOs have been provisionally accepted for 2023, which is less than half of those who applied.
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As the largest payer in the US, the Centers for Medicare and Medicaid Services (CMS) ensures more than 170M individuals through programs such as Medicare, Medicaid, the Children’s Health Insurance Program (CHIP), and the Health Insurance Marketplace. Their health equity framework is built in alignment with the Healthy People 2000 Framework, which incorporates health equity as a guiding goal for all programs of the Department of Health and Human Services. In 2015, CMS published its Equity Plan for Quality Improvement in Medicare. The effort expanded to include more efforts to improve understanding of the agreement, develop and share solutions to reduce disparities, and promote sustainable action to achieve health equity across the Agency and its partners.
Because of the widespread influence that CMS has over many health insurance programs, including Medicare and Medicaid, those actions and requirements have downstream effects on commercial markets, provider engagement and many other stakeholders. We will explore other aspects of health equity through the CMS lens in future articles.
With the goal of a systematic approach to the creation and use of health equity measures, the National Quality Forum (NQF), brings together experts to develop a road map of how performance measures and policies can be used to eliminate disparities.
In particular, the NQF roadmap describes “sensitive metrics of disparities.” This is the measure that, among all NQF-validated measures, has significant quality gap disparities when stratified for race and ethnicity. Figure 2 shows an example of a sensitive metric of disparities.
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Figure 2: NQF examples of disparities-sensitive measures. Source: NQF A Roadmap to Promote Health Equity and Eliminate Disparities: The Four I’s for Health Equity
In the Institute for Improvement’s (IHI) 2021 Pulse Report, they highlighted the results of a poll completed by 380 US-based professionals. Fifty-eight percent of respondents said health equity is a top three priority in 2021 compared to 25% in 2019. equity.
The IHI white paper and framework provide “practical advice, actionable steps, and a conceptual framework that can guide any healthcare organization in planning its own journey to improve health equity.”
As part of the institutional decline
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