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An internal analysis of three CMS Innovation Center models revealed instances of implicit bias in healthcare, which disproportionately impacted people of color and low-income individuals.
CMS Innovation Center chief medical officer Dora Lynn Hughes, MD, MPH, and analyst Melissa Majerol, MPH, disclosed the results of the analysis of implicit bias in a Health Affairs Forefront blog post yesterday. The analysis is part of the Innovation Center’s new strategic plan that focuses on five objectives, one of which is to advance health equity.
Under the Innovation Center’s advancing health equity objective, the Center aims to evaluate models for how they affect health equity and boost the number of beneficiaries from underserved communities that receive care through value-based payment models.
Hughes and Majerol reported that the Kidney Care Choices (KCC) Model, Comprehensive Care for Joint Replacement (CJR)Model, and Million Hearts® Cardiovascular Risk Reduction Model all contained some implicit bias, which led to the exclusion of some beneficiaries from the alternative payment and care delivery models.
The three models represented “a small but varies microcosm of the Innovation Center portfolio,” Hughes and Majerol explained. The models represent voluntary, mandatory, and voluntary-mandatory hybrid models and they differ according to financial methodology, beneficiary attribution, risk stratification, and financial risk levels. The authors noted that all three of the models serve diverse populations, but none were designed to reduce healthcare disparities as they were created and put into effect before the Innovation Center’s strategy refresh.