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Health equity remains at the forefront of our nation’s most pressing policy issues. The current Administration has Health equity remains at the forefront of our nation’s most pressing policy issues. The current Administration has committed to reaching historically underserved communities. This is reflected by the Centers for Medicare and Medicaid Services’ (CMS) new strategic plan, which incorporates principles of health equity. C-TAC is advancing the conversation around health equity as a catalyst for conversation between a wide array of stakeholders. Our 2021 National Summit convened thought leaders, agency officials, and experts to explore equity practices in serious illness care during unprecedented panel discussions that underscored the alignment of our Core Principles for Care Models with the national agenda.
During a special summit session on equity in care models, thought-leader, Rev. Donne Anderson shared her thoughts on the need to expand the meaning of healing to more than healing the disease—but rather the entire person. This set the stage for the Director of Patient Care Models Groups at the CMS Innovation Center (CMMI), Chris Ritter, to discuss how CMMI operates through a health equity approach to address the needs of patients. Ritter detailed the outlook of the agency stating, “there has been a movement to understand much more than we have in the traditional modern age–that everything is integrated.” With the strategy refresh, CMMI is looking towards methods like data collection to understand social determinants of health and assess other indicators of the underserved. Incorporating health equity goals into key CMMI structures, including statutory authority to modify payment or quality, is one method CMMI is utilizing to impact those payment levers.
The statutory limitations of the Medicare and Medicaid programs create obstacles for what CMS can pay for. However, Ritter shared, “in the Innovation Center we try to work as creatively as we can within the bounds of the law that we have.” Reaching out to safety net hospitals and other community-based organizations to hear directly from those receiving services, provides an opportunity for CMS to adjust models to best serve their intended populations.
Adjusting to an equity-focused approach is not without its challenges. Ritter stated, “the current leadership has [sort of] given the nod to recognize, there may be times when we’re looking at investing in different approaches, it may need longer or different ways of looking at the return.” This requires CMS to rethink the “ROI” on these investments and broaden health care solutions outside of the more traditional ideas. Ritter acknowledged that by supporting the small things provided by community organizations, that avoid emergency room visits and help maintain that person’s quality of life, patients can receive care more responsive to their needs. “I 100% agree we need to do more thinking about how to connect up, Ritter said. Ritter’s comments on integration demonstrate an alignment with C-TAC’s Core Principles, which assert that integration best supports patients.
Joining Ritter, were Dr. Mai Pham, MPH, President & CEO, of Institute for Exceptional Care, and Jayla Sanchez-Warren, Director of Area Agency on Aging at Denver Regional Council of Governments. Both echoed similar thoughts. Pham’s comments emphasized the need for statutory change for agencies and organizations effectively assist serious illness populations. “If you want a unified, aligned approach across different social and health programs, to solve a problem, you need to give them the authority and resources to do that” Pham said. In line with Rev. Anderson, Pham stressed the need to rethink care and treatment when it comes to patients. Rather than medicalize every aspect of care that a patient intersects with, there are opportunities to focus on the non-medical parts that are still a part of patient care. Sanchez-Warren shared many examples of non-medical needs that impact medical care. “Referrals don’t change health outcomes, services do” summed Sanchez-Warren’s comments and highlighted, again the importance of integrating services when considering what should be considered patient care.
C-TAC supports initiatives that center health equity and equity-informed approaches to care. This year’s summit brought our field together during an unprecedented window of opportunity for progress and we will continue to act as a bridge between stakeholders as we advocate for transformative policy that improves the life of all people with serious illness.
The 2021 Summit is available to view on-demand here until January 31, 2022.
Written by: Jennifer A. Blemur, Esq., C-TAC Director of Policy and Advocacy