HealthMay 01, 2024

What does the CMS Health Equity Index mean for payers?

Focusing on data will help payer care management teams improve member experiences to address the CMS Health Equity Index. 

Industry experts Allison Combs, Mitch Collier, and Ian Strayer led an informative webinar sponsored by Wolters Kluwer, focusing on payer strategies ahead of the Centers for Medicare & Medicaid Services (CMS) Health Equity Index implementation. Hosted by Smartbrief, the one-hour session shed light on crucial tactics that could affect health plans, Star strategies, member experiences, and overall health outcomes.

The importance of personalized solutions

Panelists emphasized the rising importance of personalized healthcare solutions as an avenue to drive health equity. Webinar discussions centered around the need for health plans to engage in proactive outreach and education, addressing barriers to health with tailored services that go beyond clinical care. A poignant example underscored the innovation in the sector, with health plans joining forces with employer groups to deliver meals — illustrating the power of customized service delivery.

Collaborating for a cause

Collaboration was a common theme throughout the webinar. Achieving health equity is no small undertaking; it necessitates integration and a commitment to cooperation among health plans, providers, and community partners. The panelists discussed the critical role that data governance plays in realizing accurate, actionable insights that can drive equity-focused interventions. 

The speakers stressed the importance of collecting impactful data on social determinants of health (SDOH) - conditions under which people are born or live that can lead to health disparities and are often also referred to as social drivers of health - noting this task needs to be a shared priority of all stakeholders in the healthcare system. Only through concerted, united efforts can this challenge be met, and solutions designed that meet diverse community needs.

Trust and transparency in healthcare

Trust is the cornerstone of successful patient and member interactions with healthcare providers. To truly address health equity, organizations will have to acknowledge that historically marginalized communities still struggle to trust traditional healthcare and will need additional support and outreach to build or regain confidence in the system. This webinar took the opportunity to underscore the value of transparency, authenticity, consistency, and the need for adapting healthcare delivery to the unique context of these communities.

Building trust requires more than policy changes and data collection. It involves leveraging relationships with respected local figures, such as religious leaders and grassroots organizers, to bridge gaps and hold the healthcare system accountable to the patients it serves.

Preparing for the health equity index

A significant portion of the webinar was dedicated to how payers could prepare for the impending Health Equity Index. Topics ranged from strategies to improve Star ratings to creating intervention programs specifically designed to improve health outcomes in underserved populations. The panelists predicted that the Index would cause scoring fluctuations, with some measures likely to decrease and others to increase, implying a need for payers to innovate in response to these changes.

The realignment of services to incorporate culturally sensitive materials and resources was marked as a pivotal means to connect with members, enhance engagement, and foster understanding. Payers were encouraged to step outside the traditional boundaries of healthcare service delivery and consider partnering with non-traditional vendors that offer more customized services.

How to rewatch the webinar

For those who missed the live session or wish to revisit these concepts, watch the full webinar recording to glean in-depth insights into preparing for and prospering in an era defined by the CMS Health Equity Index.

Rewatch the webinar by completing the form below.


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