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  • Writer's picturePrashna Raniga

CMS Framework for Health Equity and its implications for your facility.

Table of Contents

  • What is CMS Framework for Health Equity?

  • Steps facilities can take to comply to the CMS requirements

  • How can the CMS Heath Equity Framework benefit Healthcare Facilities?

  • Existing solutions to ease the journey towards health equity

  • Getting ahead of the CMS programs with Relic AI 

Article Excerpt

The CMS has launched its new program for health equity with a framework to provide equitable health care for the US population, irrespective of background, demographics and cultural differences. With the CMS Health Equity Framework, taking effect in 2024, healthcare facilities are currently planning improvements to their services in order to comply and increase their standards of care and accessibility. Developments such as language access within the facility, data collection and analysis as well as more collaborations are means to approach the CMS proposed changes. In this article, we discuss the CMS framework, its implications and benefits for your healthcare facilities. We also explore the benefits of the framework, some existing solutions for this program and share some efficient AI technologies to make your journey towards health equity smoother.

In an effort to address health disparities and promote equity in healthcare delivery, the Centers for Medicare and Medicaid Services (CMS) has recently developed a framework for health equity, effective as from 2024. The CMS strives to identify and eliminate systemic barriers to equal care so that everyone has a fair and just opportunity to excellent healthcare regardless of ethnicity, race, gender, disability, sexual orientation, language, socioeconomic status, location, or other factors that could affect health outcomes.


This new framework presents a paradigm shift for care providing facilities, as it requires providers to take proactive steps towards achieving equitable healthcare among the populations they serve. In this article, we will explore what the CMS framework for health equity and minority health entails. Here, we'll also discuss the framework's implications for your healthcare facility.


What is CMS Framework for Health Equity?

Before delving into the CMS framework, it is essential to understand what health equity means. Health equity refers to the absence of disparities in healthcare access, quality, and outcomes among different population groups. It emphasizes the fair and just distribution of healthcare resources to ensure that everyone has the opportunity to achieve optimal health.


The CMS framework for health equity outlines key steps healthcare facilities can take to promote health equity. It consists of five key components.


the five key components of cms framework for health equity

As healthcare facilities begin planning for the CMS health equity framework, there are effective and consistent ways in which they can implement the five priorities listed by the CMS, with the purpose of making healthcare equitable for the entire population.


Steps facilities can take to comply to the CMS requirements


1) Identification of underserved populations

As of 2024, facilities can intensify their efforts in collecting data, through surveys, feedback and other means, in order to address the disparities in underserved populations more effectively.


It would be beneficial for facility leaders to establish such infrastructures to collect, analyze, and share data related to demographic factors. This data can provide keen insights into the disparities that exist and help healthcare facilities design targeted interventions to address them. This step would help healthcare providers implement priority 1 but provide insight into how they can implement priorities 2, 4 and 5 from the CMS health equity framework into their facilities.


As shared in the CMS health equity conference 2023:

"The CMS Office of Minority Health has designed an interactive map, the Mapping Medicare Disparities (MMD) Tool, to identify areas of disparities between subgroups of Medicare enrollees (e.g., racial and ethnic groups) in health outcomes, utilization, and spending. It is an excellent starting point to understand and investigate geographic and racial and ethnic differences in health outcomes. This information may be used to inform policy decisions and to target populations and geographies for potential interventions."


In addition to the MMD tool, with regards to data analysis, collection of data on SDOH and data interpretation, cloud-based healthcare software which are secure and reliable are essential to implementation of CMS requirements. These will help your facility prepare for annual audits and regulatory compliance, provding ease of access to large amounts of data and help improve your facility's equity metrics rating.


2) Providing culturally and linguistically focused services

Priority 4 of the framework would require healthcare facilities to provide prompt and effective language access to patients and their families.


With the core focus of the CMS program being to make healthcare accessible to patients, including underserved and marginalised populations, irrespective of their cultural, societal background, upbringing and language barriers, healthcare facilities are expected to provide service delivery sensitive to cultural preferences, beliefs, and practices of diverse patients. These services could include interpretation services, recruiting a diverse workforce, or creating policies and procedures that promote cultural competence within your facility.


3) Collaborating within the community

Facilities would benefit from increased networking and establishing partnerships with community-based organizations, public health agencies, and other stakeholders, in order to comply with priority 2, 3 and 5 of the health equity framework.


Collaborative initiatives could include improving access to healthcare, reducing health disparities, and promoting community health. Leadership structures and processes that demonstrate a commitment to health equity, should be established in your faclity. The aim of those structures should be to integrate health equity goals into strategic planning, governance, and decision-making processes, which would help your facility thrive in it's journey towards providing equitable healthcare.


How can CMS Heath Equity Framework benefit healthcare facilities?

The CMS framework for health equity can set your facility on a path to address health disparities and at the same time improve health outcomes towards the population you serve. By adopting this framework, your healthcare facility can enhance patient care, improve health outcomes, and build trust within the community.


Improved outcomes for the facility and its patients

By prioritizing health equity, healthcare facilities are likely to see improved health outcomes for marginalized populations. Your facility can enhance the quality of care and improve it's CMS Five-Star Quality rating by addressing underlying social determinants of health and tailoring services to diverse patients' needs, healthcare facilities.


Tech solutions such as Inovalon, for instance, can be used to helping facilities identify and address health disparities using their benchmarking analytics software. Facilities could gain a better understanding of how they would perform with regards to their data, including demographics and SDOH, on the new CMS Health Equity Index.


Patient-centered care and increased trust in the facility

Healthcare facilities that deliver culturally and linguistically appropriate services create a more inclusive and patient-centered care experience. Patients from diverse backgrounds will feel more understood, respected, and empowered to actively participate in their healthcare decisions. As of 2024, to adhere to the framework, facilities are required to demonstrate the availability of those services. If your facility is not prepared to provide these services, Relic AI can help.


Community trust, collaboration and increased presence

Through partnerships with community-based organizations, public health agencies, and other stakeholders, your facility can build trust and engage with local communities. This collaboration fosters a deeper understanding of community needs, improves access to healthcare, and encourages community ownership of health equity initiatives. Increased collaborations would also benefit facilities as they grow to become more renowned within the served area and community.


Competitive advantage over other healthcare providers

Healthcare facilities that prioritize health equity are likely to gain an advantage over their competitors in an increasingly diverse healthcare landscape. Patients and payers increasingly seek healthcare providers that embrace diversity, excellent accessibility, inclusion, and equity.


The CMS framework for health equity therefore presents a unique opportunity for healthcare facilities to address health disparities and promote health equity. By adopting this framework, healthcare facilities can improve patient care, enhance their competitive edge, and build trust in the community.


Existing solutions to ease the journey towards health equity

Despite the challenges faced by healthcare providers and the scarcity of solutions to address them, such as nursing staff shortage, staff burnout and reduced financial resources, there are some technological solutions which are available to help facilities in their journey towards health equity.


Data analysis software

Tech solutions such as Inovalon, for instance, can be used to helping facilities identify and address health disparities using their benchmarking analytics software. Facilities could gain a better understanding of how they would perform with regards to their data, including demographics and SDOH, on the new CMS Health Equity Index.


Interpretation services

Directors can seek services from interpreters, or explore the use of interpretation services from companies such as CQ Fluency for documents, contracts, brochure and handbook translations.


AI Solutions

The role of Artificial Intelligence in healthcare has been growing. Your facility can deploy AI solutions to get better insights into patient population that you serve. Two example solutions are given below.

Closed Loop AI

The award winning data science platform, ClosedLoop AI, can help healthcare organizations improve their services to become more equitable. Closed Loop AI, helps improve outcomes and reduce unnecessary costs with accurate, explainable, and actionable predictions of individual-level health risks.

Komodo Health

With a large database of 330 million patients who have gone through the healthcare system, the innovative health tech company, Komodo Health, provides clinical insights gained through analytics. In addition to tracking new treatment outcomes and identifying new patients for clinical trials, Komodo Health can also help facilities reduce disparities in the care they provide.


Getting ahead of the CMS programs with Relic AI

At Relic Care, our mission is to provide 24 x 7 equitable care. Relic AI can help your facility deliver patient care aligned with the new framework, by providing you with the tools required for care accessibility and data collection aspects of the CMS program. Conversational AI services provided by Relic care can equip your facility with adequate data for reference, auditing and further improvement of your services. Additionally, transform your facility into a multi-lingual one, without significant investments. Relic AI's ability to have conversations in 50+ languages, depending on the patients' and families' needs, can help extend the reach of your facility's services to underserved patient populations. Relic Care could be your trusted partner in prioritizing advanced language access, health literacy and providing culturally tailored services, in line with the CMS demands.

 

Article reviewed by Prashna Raniga PhD.


Prashna Raniga leads Sales & Partnerships at Relic Care. Prashna works closely with healthcare facilities interested in deploying Relic AI, introducing AI solutions to Healthcare. Prashna has over 8 years of experience managing and running Skilled Nursing Facilities. With a doctorate in Biochemistry & Biophysics, Prashna has spent her entire career understanding healthcare not only from a clinical perspective but also looking at operational realities in delivering healthcare outcomes for patients. If you are interested in Relic AI, you can write at prashna@reliccare.com.

 

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