CMS Provides Updates on Its Focus on Health Equity

Post Written by Sarah Dunbar, Business Solutions Associate

Quarterly, CMS provides stakeholders with the opportunity to hear information related to policies or initiatives that CMS has prioritized. This time, CMS shared updates on their work around health equity.

On July 19, the Centers for Medicare and Medicaid Services (CMS) leadership team held a national stakeholder call with the aim of reviewing their accomplishments and setting the stage for key initiatives moving forward, as it relates to their work on health equity. This is only the second call after the release of CMS’ six strategic pillars: advancing health equity, expanding access, engaging partners, driving innovation, protecting program sustainability, and fostering excellence. 

What is CMS’ Framework for Health Equity?

As the nation’s largest insurer, CMS acknowledges that they play a critical role in advancing health equity among all people, especially for those that are underserved. This not only strengthens the current healthcare system, but fosters better benefits and health advancements for future generations. The CMS framework for health equity outlines a commitment to structural change and collaboration that will eliminate barriers to benefits, services, and coverage for underserved individuals and communities. 

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, sexual orientation, gender identity, socio-economic status, geography, preferred language, and other factors that affect access to care and health outcomes. This framework and its initiatives began with the 2015 CMS Equity Plan for Improving Quality in Medicare and transformed through continuous stakeholder engagement and evidence-based reviews to its current form.

So how exactly has CMS advanced equity?

The opening remarks by CMS Administrator Chiquita Brooks-LaSure outlined CMS’ commitment to advancing health equity and provided tangible examples of actions taken to advance health equity. 

In June, the White House released the Bidden-Harris Administration’s blueprint for addressing the maternal health crisis, which provided an approach to combating maternal mortality and morbidity. These ongoing efforts and dedication to addressing maternal health disparities, particularly for those in rural communities is mirrored by CMS’s expansion of postpartum coverage and maternal health services. As a push towards improving health equity and addressing issues in the maternal health crisis, postpartum coverage will provide Medicaid and CHIP coverage for twelve months postpartum. This creates an easier pathway to support the health and well-being of postpartum women and families, by eliminating barriers to coverage and health services.

CMS also supports expanded access to home and community-based services (HCBS). HCBS provides individuals who need assistance with everyday activities the opportunity to receive services (such as personal care, homemaker, and adult day health services) in their own homes or the community as opposed to institutional settings. Last year, state Medicaid programs received funding for HCBS, raising the federal matching rate spending by ten percentage points from April 2021 through March 2024, and currently accounts for $125 billion annually in state and federal funding. The American Rescue Plan (ARP) has given CMS new opportunities to expand services and strengthen the HCBS provider workforce. With over 7 million people receiving HCBS under Medicaid and Medicaid funded HCBS accounts, CMS reinforced its commitment to improved health outcomes and quality, by releasing the first-ever HCBS quality measure set to promote consistent measurement within and across state Medicaid HCBS programs. Data is essential for identifying where disparities exist, and directing efforts and resources to address disparities as they are identified. Despite advances in HCBS services, there are notable gaps and challenges related to quality. To achieve greater equity requires accountability, these measure sets will allow CMS and states to collect and utilize adequate data so that inequities and disparities do not remain unseen and unaddressed. Participation remains voluntary at this time, however, HCBS providers should keep in mind that CMS plans to incorporate use of the measure set into the reporting requirements for specific authorities and programs. 

Preparing for the Public Health Emergency (PHE) Wind Down

CMS focused some conversation on their strategy to transition out of the PHE. CMS outlined a responsibility to ensure that states are prepared for Medicaid redeterminations and to  support all people with the opportunity to maintain insurance coverage. This also means preparation for the eventual coverage for vaccine, testing, and treatment of COVID-19 by Medicare, Medicaid, and Private Insurers past the PHE timeframe. CMS plans to determine which provider waivers to maintain, sunset, or reissue as they work towards a PHE wind down. The PHE has exposed long-standing, historical and contemporary inequalities that affect the public health infrastructure and has contributed to significant increases in insurance coverage since 2020. The PHE wind down might re-expose health equity issues given that Black, Latino/a and other people of color are most at risk of coverage loss due to volatile and unstable employment and housing. The redeterminations processes will be key in ensuring that coverage retention efforts include a deep equity focus. 

What Else?

With much excitement, CMS discussed the nationwide transition to the 9-8-8 Suicide & Crisis Lifeline. The successful transition to an easy-to-remember number to reach trained crisis counselors for help with suicide, mental health, and substance abuse-related crises has increased total volume of calls, texts and chats by 45%. CMS continues to solidify its commitment to promoting behavioral health policy and expanding access to programs.

It is without question that health equity is a foundational element across all of CMS’ work and continues to evolve in new models such as ACO REACH. Are you an ACO REACH provisionally-approved entity searching for support in the health equity component of the program requirement? We are engaged in this work and can help you on your journey to value. Drop us a line, send us a note, let us collectively uncover the gaps in health outcomes and advance quality improvement and meaningful change.

About the Author: Sarah Dunbar is a Business Solutions Associate at Helgerson Solutions Group. Connect with her on LinkedIn.