GNYHA recently hosted a forum on the Robert Wood Johnson Foundation’s Advancing Health Equity (AHE): Leading Care, Payment, and Systems Transformation program. AHE offers a framework to advance health equity that can be integrated into existing quality and safety activities by creating a culture of equity, identifying a health equity focus, and diagnosing and prioritizing root causes.
“There’s no such thing as high-quality care that is inequitable; equity is a fundamental dimension of quality,” said GNYHA’s Erin DuPree, MD, Senior Vice President and Physician Executive, Quality and Clinical Initiatives.
AHE co-directors Marshall Chin, MD, MPH, and Scott Cook, PhD, discussed their work at the University of Chicago Medicine (UChicago Medicine). They noted that while much has been learned about inequities and interventions to reduce them over recent decades, the problem persists due to key conceptual weaknesses: ignoring structural racism and not addressing how power operates in the nation’s health care system. They highlighted the major elements and foundational activities necessary to create a sustainable approach to reduce or eliminate health inequities, which are key elements of the health equity requirements and standards from The Joint Commission (TJC) and the Centers for Medicare & Medicaid Services (CMS).
Dr. Chin and Dr. Cook recommended a three-pronged approach to build sustainable equity: fostering system transformation to address medical and social needs of individuals and communities, creating a culture of anti-racism that addresses structural issues, and employing payment reform that supports and incentivizes care transformation to address the medical and social drivers of health inequity. They emphasized that all three aspects were necessary components to sustaining improvements.
As part of the Federal fiscal year 2023 Inpatient Prospective Payment System Hospital Inpatient Quality Reporting program, CMS adopted a health equity measure to assess a hospital’s commitment to establishing a culture of equity and delivering more equitable health care across five key domains: strategic planning, data collection, data analysis, quality improvement, and leadership engagement. Effective July 1, 2023, TJC’s Health Care Equity Standard (LD.04.03.08) was promoted as a new National Patient Safety Goal (NPSG.16.01.01), Goal 16: improve health care equity, and was revised to focus on improving health care equity as a quality and safety priority.
Previous GNYHA meetings provided information on components of and data analysis and quality measures included in the CMS and TJC health equity requirements. GNYHA will continue to support and provide resources to help member hospitals meet these new measures and requirements.