On April 20, 2022, the Centers for Medicare and Medicaid Services (CMS) released an action plan on the first pillar of its Strategic Plan demonstrating its commitment to health equity. CMS’ health equity strategy will build on the Biden-Harris Administration’s commitment to advancing racial equity and support for underserved communities through the federal government, as described in President Biden’s Executive Order 13985.
CMS calls on its private sector partners to engage with its health equity strategy to sustain long-term action. CMS plans to convene industry stakeholders to ensure progress on the initiatives. The first meeting will take place in summer 2022 and focus on ways to improve maternal health outcomes experienced by pregnant and postpartum people. CMS and experts will invite health care industry leaders to share best practices and commitments to strengthen maternal health.
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, and other factors that affect access to care and health outcomes.
CMS is working to achieve health equity for all people served by its programs. CMS’ overarching goals for realizing health equity are:
- Close the gaps in health care access, quality, and outcomes for underserved populations
- Promote culturally and linguistically appropriate services
- Build on outreach efforts to enroll eligible people across Medicare, Medicaid/CHIP and the Marketplace
- Expand and standardize the collection and use of data, including on race, ethnicity, preferred language, sexual orientation, gender identity, disability, income, geography, and other factors across CMS programs
- Evaluate policies to determine how CMS can support safety net providers
- Ensure engagement with and accountability to the communities CMS serves in policy development and the implementation of CMS programs
- Incorporate screening for and promote broader access to health-related social needs
- Ensure CMS programs serve as a model and catalyst to advance health equity through our nation’s health care system, including with states, providers, plans, and other stakeholders
- Use the framework under the CMS National Quality Strategy, aiming to promote the highest quality outcomes and safest care for all people
Each Office/Center within CMS detailed key actions to take in their efforts to advance health equity:
Center for Medicare
- Increase Graduate Medical Education slots to promote workforce training in underserved areas to improve access to care.
- Develop expanded stratified reporting of Medicare Advantage (MA) and Part D Star Ratings measures and add a new health equity index to the Star Ratings to allow beneficiaries to assess plans based on health equity measures.
- Propose to reinstate the requirement for MA and Part D plans to include a multi-language insert to inform beneficiaries of free language and translation services to advance culturally tailored services for all beneficiaries.
- Propose new supplemental payment for Indian Health Service and Tribal hospitals.
Center for Clinical Standards and Quality
- Propose a “Birthing-Friendly” hospital designation to help consumers choose hospitals that have implemented improvements in birthing practices.
- Explore the development of health equity-focused measures in all care settings.
- Directing quality improvement resources to populations identified for the greatest health disparities using social vulnerability index, area deprivation index, and food access data.
Center for Medicare and Medicaid Innovation
- Address historical underinvestment through payment adjustments or enhanced benefits to expand access and improve care for underserved populations.
- Improve rates of participation among safety net providers like community health centers and disproportionate share hospitals to ensure beneficiaries in underserved communities receive the benefits of CMMI’s innovative models. Incorporate equity in model design to ensure equity is the central focus.
- Increase collection of sociodemographic data.
Medicare-Medicaid Coordination Office
- Support providers in delivering disability-competent and accessible care.
- Improve access to the Medicare Savings Programs through public outreach and partnership with states.
- Improve coordination between Medicare and Medicaid for people dually eligible for both programs through proposed rulemaking to strengthen dual eligible special needs plans, elevate the voices of enrollees in plan governance, and better identify and address housing instability, food insecurity, and barriers to transportation.
Center for Medicaid and CHIP Services
- Roll back restrictive practices that prevented access to coverage and care.
- Improve access to continuous coverage and quality of care in the postpartum period by working closely with states to encourage uptake of 12 months of extended postpartum coverage for pregnant people.
- Work with states to identify opportunities to connect justice-involved individuals with community-based services immediately upon release.
- Expanded access to home- and community-based services (HCBS) through the American Rescue Plan (ARP). ARP provided states with a temporary 10% increase to federal funding for some Medicaid HCBS.
Center for Consumer Information and Insurance Oversight
- Acted to decrease the number of single-issuer rural counties in the individual market by incentivizing issuers to enter service areas to increase choice and affordability for rural communities.
- Consider strengthening Health and Human Services essential community provider requirements.
- Increase federally facilitated Marketplace enrollment among underrepresented populations by 25% to reduce uninsured rate among underserved populations.
- Consider new requirements for network adequacy for qualified health plans on the Marketplace for 2023.
- Consider requiring issuers of qualified health plans in Marketplaces using the federal platform to offer standardized plans so consumers can compare options easily.
- Promulgate new regulations under the No Surprises Act related to surprise medical bills and unexpected health care costs.
Office of Minority Health
- Provide technical assistance through the CMS Health Equity Technical Assistance Program to support all stakeholders as they work together to embed health equity within CMS programs, policies, and operations.
- Create and distribute provider training materials to help health care professionals understand the needs of those they serve.
- Expand community outreach efforts to gain valuable insight from stakeholders to provide CMS with current information about the diverse needs of each community it serves.
Office of Communications
- Continued support and outreach for Medicare beneficiaries on Medicare Savings Programs and other cost-savings programs.
- Expand culturally competent and linguistically accessible education campaign outreach to increase reach in historically underserved communities.
- Translate the “Medicare & You” handbook and other educational materials for Medicare beneficiaries into additional languages to increase accessibility of programs and resources.
For further questions, please contact Alexa McKinley, NRHA Government Affairs and Policy Coordinator, at email@example.com or another member of the Government Affairs team.