Pursuing Health Equity Through Regulation and Reimbursement-PYA GHA Health Equity with Audio Presentation2

PYA GHA Health Equity with Audio Presentation2

Pdf Summary

The document discusses efforts to pursue health equity in the U.S. through regulation and reimbursement. Key motivations include Executive Orders 13985 and 13995, which emphasize advancing racial equity and an equitable pandemic response. The document highlights disparities such as higher infection, hospitalization, and mortality rates among racial minorities, and emphasizes the need for health equity, defined as equal opportunities for optimal health regardless of race, ethnicity, etc.<br /><br />The paper outlines priorities for health equity, such as improving data collection, assessing disparities in healthcare programs, and enhancing language access and healthcare literacy. CMS (Centers for Medicare & Medicaid Services) is taking steps toward this through various initiatives, including the Accountable Health Communities Model, which focuses on identifying and addressing health-related social needs, and the Hospital Readmission Reduction Program, which stratifies hospitals by patient demographics to address disparities.<br /><br />CMS also emphasizes the importance of standardized data collection for social determinants of health (SDOH) in post-acute care through SPADEs, and the ACO REACH Model which addresses health equity with requirements like health equity plans and data collection.<br /><br />Proposed rules for 2023, such as in the IPPS and Medicare Physician Fee Schedule, include measures for equitable care, like screening for social risk factors and enhancing payment adjustments based on social and economic determinants of health.<br /><br />Overall, the document outlines a comprehensive regulatory and policy framework aimed at eliminating health disparities, enhancing equity-focused data collection, and incentivizing equitable care through strategic CMS initiatives and reimbursement structures.

Keywords

health equity

Executive Orders 13985 13995

racial disparities

CMS initiatives

social determinants of health

Accountable Health Communities Model

Hospital Readmission Reduction Program

SPADEs

ACO REACH Model

Medicare Physician Fee Schedule