In recent years, momentum among Accountable Care Organizations (ACOs) to improve health equity has increased. The Centers for Medicare & Medicaid Services’ announcement of the redesigned ACO REACH contracting model to improve health equity will only accelerate this momentum.
In this blog, we will help ACOs and healthcare payers understand how healthcare analytics can be used to identify health equity challenges and track improvement initiatives’ progress.
What is Health Equity?
The White House and CMMI define the term “equity” as the consistent and systematic fair, just, and impartial treatment of all individuals, including individuals who belong to underserved communities that have been denied such treatment, such as Black, Latino, and Indigenous and Native American persons, Asian Americans and Pacific Islanders and other persons of color; members of religious minorities; LGBTQ+ persons; persons with disabilities; persons who live in rural areas; and persons otherwise adversely affected by persistent poverty or inequality.
Given this definition, health equity refers to the ability to provide the same level of care and treatment outcomes regardless of demographic factors such as a patient’s income, location, gender, or race. These factors, known as Social Determinants of Health, have been shown to lead to unequal health costs and outcomes among specific population segments. Examples include:
- Geography: rural communities may struggle with care access due to a lack of facilities in their area, the majority of which might require longer travel times.
- Language: non-native-English speakers may struggle to understand provider conversations or medication instructions, leading to treatment difficulties.
- Adverse Childhood Events (ACE) Score: a higher frequency of negative experiences in childhood and teenage years may put children at risk for chronic health problems, mental illness, and substance use in adulthood.
- Income Level: lower-income individuals often lack insurance coverage and, as a result, tend to put off care until an emergency arises. Even for lower-income individuals with insurance, copays and deductibles can cause barriers to receiving care. These individuals often rely on emergency care for chronic conditions that could have been treated much earlier, which drives up care costs.