CMS Health Equity Requirements
Hey there healthcare folks! Let’s talk about the most recent CMS health equity requirements.
Hospital Commitment to Health Equity Measure
First up – the Hospital Commitment to Health Equity (HCHE) measure. It’s like CMS’s way of saying “prove you care about health equity.”
What’s the deal?
- Mandatory as of 2023
- You’ve got to pinky promise you’re committed to health equity
- There are five domains they’re checking (more on that in a sec)
The five domains are basically CMS’s health equity report card:
- Making equity a strategic priority (not just a buzzword)
- Data collection (because you can’t fix what you can’t measure)
- Language access (interpreters and bilingual staff)
- Community partnerships (yes, you have to play nice with others)
- Leadership engagement (your C-suite needs to care too)
Health Equity Index in Star Ratings
Coming to a Medicare Advantage plan near you in 2027 (for 2028 payment):
- New health equity focus in Star Ratings
- Extra points for helping folks with social risk factors
- Special attention on low-income and disabled beneficiaries
Data Collection and Reporting Requirements
CMS wants ALL the data:
- Race and ethnicity
- Preferred language
- Sexual orientation
- Gender identity
- Disability status
- Income
- Geography
Utilization Management Evaluation
For my Medicare Advantage friends:
- Annual health equity analysis of prior auths
- Compare metrics between different social risk groups
- Put it all on your website (because transparency)
Screening for Social Drivers of Health
New for 2024:
- Hospital Screening measure
- Gotta check adult patients for health-related social needs
- Yes, this will affect your quality scores
CMS Framework for Health Equity 2022-2032
The big picture plan (aka CMS’s 10-year health equity wishlist):
- More data collection (shocking)
- Figure out why disparities exist and fix them
- Build better healthcare teams
- Improve language access and cultural services
- Make healthcare more accessible (novel concept, right?)
Additional Stuff You Need to Know
- Your UM committee needs health equity experts
- Support those safety net providers
- Cultural competency isn’t optional anymore
- Get more people enrolled in Medicare/Medicaid/CHIP
In summary Is this a lot? Yes. Is it necessary? Also yes.
The goal is actually pretty solid: better healthcare for everyone, regardless of their background.
My advice? Start working on this stuff now, especially the data collection piece. Trust me, you don’t want to be scrambling when the deadlines hit.