The Centers for Medicare & Medicaid Services (CMS) Office of Minority Health's (OMH) mission is to eliminate health disparities among all Medicare minority populations, including racial and ethnic minorities, people with disabilities, members of the lesbian, gay, bisexual, and transgender community, and rural populations. These populations often experience disproportionately high burdens of disease, worse quality of care and barriers to accessing care.
For this reason, OMH developed the CMS Equity Plan for Improving Quality in Medicare, which provides an action-oriented, results-driven approach for advancing health equity. CMS’ path to health equity focuses on increasing understanding and awareness of disparities, creating and disseminating promising solutions, and implementing sustainable actions.
“We are making steady progress on the six priorities in the Equity Plan, which all fit into OMH’s USA framework to spread Understanding of disparities and Solutions and institute collective Action to increase health equity,” said Dr. Madeline Shea, Deputy Director, OMH. “Our goal is to ensure that all CMS beneficiaries have achieved the highest level of health, and that disparities in health care quality and access have been eliminated.”
Below we take a look at the focus and progress of the Equity Plan’s six priority areas:
1) Expand the Collection, Reporting and Analysis of Standardized Data
Data is required to address changes among target populations over time; thus, this is an important first step toward improving population health among minority populations. Last month, OMH released a Medicare Mapping Disparities tool to help visualize disparities related to geography, race, ethnicity and disability status. “Additionally, new tools on how to collect data will be released shortly, as well as Medicare Advantage Plan quality and beneficiary experience data stratified by race and ethnicity,” Dr. Shea said.
2) Evaluate Disparities Impacts and Integrate Equity Solutions Across CMS Programs
Many different initiatives from CMS, the Affordable Care Act and the U.S. Department of Health and Human Services (HHS) have created opportunities to decrease disparities; however, there is not an established way to assess impact on health equity. OMH is working to increase understanding of the disparities impacts of CMS programs like the QIO Program. Dr. Shea noted, “At the 2015 CMS Quality Conference, we met face-to-face with Quality Innovation Network-QIOs to outline how disparities goals align with the Program’s current quality improvement efforts.”
3) Develop and Disseminate Promising Approaches to Reduce Health Disparities
OMH is developing, testing and diffusing promising approaches to reducing health disparities, starting with the Guide to Preventing Readmissions Among Racially and Ethnically Diverse Medicare Beneficiaries.
“Our goal is to ensure that all CMS beneficiaries have achieved the highest level of health, and that disparities in health care quality and access have been eliminated.”
4) Increase the Ability of the Health Care Workforce to Meet the Needs of Vulnerable Populations
The adequacy of the health care workforce is critical to the quality of care and health outcomes among Medicare beneficiaries. OMH is promoting a culturally competent workforce and multidisciplinary care teams by building capacity for providers to meet national culturally and linguistically appropriate services (CLAS) standards. “We are also examining how community health workers and mid-level staff are being employed in new health care delivery innovations to reduce disparities,” Dr. Shea added.
5) Improve Communication and Language Access for Individuals with Limited English Proficiency and Persons with Disabilities
This priority addresses disparities related to persons with limited English proficiency and individuals with disabilities. OMH is working to help improve communication for vulnerable populations by assessing language access needs, educating providers and sharing best practices.
6) Increase Physical Accessibility of Health Care Facilities
Individuals with disabilities experience significant disparities in health status. “There is a lack of knowledge among providers and beneficiaries about physical accessibility needs and requirements in health care settings,” Dr. Shea explained. OMH is working to measure the physical accessibility of health care facilities for people with disabilities and identify effective strategies to improve access.