Advancing Health Equity: A Long-term Commitment to Addressing Disparities

Defining Health Equity 

At its core, Health Equity is about ensuring that every individual has the opportunity to achieve optimal health, regardless of their background or circumstances. This means every individual has timely and convenient access to care, utilizes health care services appropriately, understands treatment plans (health literacy), and has personalized, culturally sensitive interactions with providers.  

Achieving Health Equity requires these four pillars to function seamlessly together to create an environment where everyone can thrive in their pursuit of health. While Health Equity is an aspirational goal—one that may not be fully realized in our lifetime—this shouldn’t deter us from striving towards it, today and every day. 

The Causes of Health Disparities 

Disparities between different population segments in the healthcare system are due to a combination of historical, socioeconomic, and structural factors. These include limited access to quality healthcare, economic inequality, systemic racism, and bias within medical practices. As a result, minority and low-income populations often face barriers such as inadequate insurance coverage, geographic isolation from care facilities, and cultural or language barriers. These disparities have led to poorer health outcomes, higher rates of preventable diseases, and shorter life expectancies for these groups, worsening health inequities and contributing to overall public health challenges. 

Why Health Equity Matters to Health Plans 

Health plans are uniquely positioned to make a significant impact on Health Equity. Not only does prioritizing Health Equity improve the health outcomes of members, it also strengthens the entire healthcare system. When health disparities are addressed, unnecessary stress is removed from healthcare providers, hospitals, and other critical sectors, ultimately reducing costs. This alignment of health improvement with cost-effectiveness creates a compelling business case for health plans to invest in Health Equity initiatives now and in the future. 

The Health Equity Index: Driving Change through Accountability 

A key tool in advancing Health Equity is the Health Equity Index (HEI), a measurement system developed by the Centers for Medicare & Medicaid Services (CMS). Initially optional, the Health Equity Index is now a requirement for managed care organizations serving Medicare populations. The index is designed to create incentives to encourage health plans to make meaningful progress toward health equity. While the index currently applies to Medicare populations who qualify for low-income subsidies, those with disabilities, and Dual eligibles, CMS has telegraphed that it could potentially expand to other populations in the future. 

Health plans that serve eligible populations must focus on measuring and tracking disparities to meet the index’s standards. This measurement-based approach forces plans to be accountable and proactive in their efforts to reduce health inequities—further integrating Health Equity into everyday care and services. 

Successful Health Equity Initiatives: A Holistic Approach 

Addressing Health Equity requires a multifaceted approach. Here are four key areas that have shaped successful initiatives: 

The People You Serve: At its most basic, this involves understanding the needs of the populations health plans serve. Focus on available population data to understand your members’ diverse characteristics. A great place to start is analyzing your data to answer these questions: 

• What disparities exist? 
• Where geographically do the disparities exist? 
• Who is most impacted by the disparities? 
• What is the order of magnitude of the disparities?  
• What are the barriers to optimal health? 

Answering these questions will help health plans determine strategies and initiatives to reduce the disparities within their unique population.  

Providers: A crucial part of achieving Health Equity is ensuring that healthcare providers are trained to understand disparities and are equipped to communicate effectively with patients. This includes helping providers recognize the cultural sensitivities and barriers that different populations may face. By improving provider training and providing incentives for addressing identified health disparities, health plans can help ensure more equitable care delivery. 

Policy: Policy changes, like the Health Equity Index itself, are essential to institutionalizing Health Equity. Policy efforts have shifted Health Equity from being a moral imperative to a business imperative for health plans and providers. Policy changes can institutionalize practices that make Health Equity sustainable in the long term. 

Partnerships: Achieving Health Equity is not something that can be done alone. Partnerships with community organizations, local health initiatives, and even tech companies (like Lyft and Uber) are necessary to address the social and personal determinants of health that often create barriers to care. Collaboration with these groups helps health plans to support the whole person, not just their clinical needs. 

What Should Health Plans Be Doing Now? 

As health plans prepare for the 2027 implementation of the Health Equity Index, the work begins today. The first step is measurement—health plans must assess whether they serve populations that fall under the index’s requirements. If they do, they must understand the size and location of these populations and develop strategies to understand the challenges in navigating their healthcare needs, how to trust the healthcare system, and learn their engagement barriers to be able to more effectively serve them. The next phase involves forming the right partnerships with providers, community organizations, and other stakeholders to ensure sustainable efforts that go beyond short-term interventions. 

The Future of Health Equity 

Looking ahead, Health Equity will remain a central goal for healthcare systems, regardless of the terminology used in the future. Health Equity represents the highest form of quality care because it seeks to remove barriers to health and ensure everyone has the same opportunity to succeed in achieving optimal health. The ongoing focus on improving health outcomes for all populations will continue to drive efforts to close the gaps in care and reduce healthcare costs, whether or not we achieve perfect equity in our lifetime. 

In the end, advancing Health Equity is not just a moral imperative but a practical one that benefits individuals, healthcare systems, and society at large. By actively working toward more equitable healthcare systems, we can ensure that everyone has the opportunity to achieve their best health, today and for generations to come.