Medicaid
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The Centers for Medicare and Medicaid Services aims to achieve health equity for underserved communities

August 1, 2022
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Health equity is one of the major public health areas of focus for governmental entities and nonprofit organizations across the United States, and the Centers for Medicare and Medicaid Services (CMS) plans to address it as well. They hope to achieve health equity for clients from underserved communities and the providers who serve those areas by applying the CMS Framework for Health Equity. This framework updates their 2015 CMS Equity Plan for Improving Quality in Medicare with a precise plan to incorporate health equity across their programs: Medicaid, Medicare, Children’s Health Insurance Plan (CHIP) and the Marketplace. Likewise, the framework will improve their policies.

 Health equity is one of the major public health areas of focus for governmental entities and nonprofit organizations across the United States.

The Framework for Health Equity consists of five priorities:

  1. Expand the collection, reporting and analysis of standardized data.
  2. Assess causes of disparities within CMS programs, and address inequities in policies and operations to close gaps.
  3. Build capacity of health care organizations and the workforce to reduce health and health care disparities.
  4. Advance language access, health literacy and the provision of culturally tailored services.
  5. Increase all forms of accessibility to health care services and coverage.

Data and metrics to support each Health Equity priority area

CMS will strategically address each priority. They intend to accomplish the first priority by internally extend collecting, reporting and stratification of data throughout their programs. They will also develop health equity reporting metrics in their quality improvement programs. In addition, they plan to increase access and availability of their data to their external partners and researchers. Based on their clients’ perspectives, CMS will focus on the second priority in order to identify and eliminate barriers they face when searching for and using their coverage, benefits and services. Furthermore, they plan to eliminate policies that prevent access to Medicaid coverage and implement 12 months postpartum coverage. Ohio and other states have been granted 12 months of postpartum coverage for their Medicaid beneficiaries.

Cultural competence and capacity building to fulfill service needs

In order to complete their third priority— build capacity of health care workforce and organizations to decrease health and disparities— CMS will determine how they can provide the needs of providers, plans and organizations who serve members from underserved communities. They want to ensure that providers and networks understand the programs’ benefits they offer for their beneficiaries. Regarding their fourth priority— advancing language and health literacy— CMS wants organizations to implement the National Standards for Culturally and Linguistically Appropriate Services (CLAS), which is a document about how health professionals can tailor their services based on a patient’s culture and language. CMS’s materials will be translated into various languages and will help their beneficiaries to understand their rights and protections within the No Surprises Act. Lastly, CMS aims to help people with disabilities and their families get enhanced accessibility to health-related social needs like nutrition, wrap-around housing supports and home modifications. Additionally, they strive to improve home and community-based services (HCBS).

 Many people from underserved communities die due to poor health outcomes deriving from disparities.

Accountability and addressing health disparities

As CMS works to provide health equity for those who need it the most, they should be held accountable. Many people from underserved communities die due to poor health outcomes deriving from disparities. As a matter of fact, continual health disparities are the reason for 60,000 excess deaths annually. CMS should update its progress on applying the Framework for Health Equity to the public. By eliminating health disparities, CMS can save lives of people from underserved communities while reaching their optimal level of health.

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