It’s no secret that health care disparities continue to plague communities. For instance, women of color face greater barriers to access health care compared to white women due to a variety of reasons, including lack of health care insurance. According to the Kaiser Foundation, among women ages 18 to 49, 24% of Hispanic, 24% of American Indian and Alaska Native, and 13% of Black women are uninsured. In contrast, 9% of white women lack health care insurance.
To address disparities like this and more, governing bodies like Centers for Medicare and Medicaid Services (CMS) and The Joint Commission created standards and metrics for providers to follow to help further overall improvements of health outcomes and eliminate disparities. This direction comes at an opportune time as many health care providers have also made concerted efforts to address a variety of social determinates of health (SDOH) by implementing environmental, social and governance (ESG) policies that directly impact the health and wellness of the communities they serve.
Hopefully this intersection of standards and ESG efforts drives innovation and prioritization to make real change when it comes to nagging health inequities. Likewise, the data and assessment needed to fulfill new standards and metrics could be useful in other areas of a health care organization. Let’s look at what’s evolving.
Tech can address disparity reporting and other needs
The Joint Commission announced new standards related to health equity as part of its health care provider accreditations starting in 2023. Some of the new standards health care organizations must fulfill include:
- Designating an individual(s) to lead activities to reduce health care disparities for the organization’s patients.
- Assessing patients’ health-related social needs and provide information about community resources and support services.
- Determining which health-related social needs to include in the patient assessment, i.e., access to transportation, difficulty level in paying for prescriptions or medical bills, education and literacy, food insecurity and housing insecurity.
- Stratifying quality and safety data using the sociodemographic characteristics of the organization’s patients.
- Determining which sociodemographic characteristics to use for stratification analyses, i.e., age, gender, preferred language, race and ethnicity.
The data requirements for establishing, monitoring and improving many of the items The Joint Commission will be evaluating could raise potential challenges for organizations already strapped for resources and labor to execute such efforts. We expect that as health care organizations continue to have operational challenges with their workforce as well as struggle with margin concerns, providers will look to technology to track and monitor the data required to meet accreditation. Organizations will need to make sure upgraded or new systems and operations are in place to do so.
Additional value to the organization
While implementing improved systems may mean slight disruptions, new processes, increased costs and added resources, there is an added bonus to these new efforts as well. As organizations compile and assess data to meet new accreditation standards, there may be other ways to use the data that provide value to the organization. Note the following.
Tax filing requirements – As many non-profit health systems continue to maintain their nonprofit status under section 501(c)(3), part of their requirements to remain compliant with 501(c)(3) is to complete their community health needs assessment (CHNA). Section 501(r)(3)(A) requires a hospital organization to conduct a CHNA every three years and to adopt an implementation strategy to meet the community health needs identified through the CHNA. Organizations have imbedded collecting data related to SDOH into their CHNA, such as surveying their community on strengths and weaknesses around access to care, quality of housing and access to healthy food, for examples. Diving into the insight of these details helps organizations stand up appropriate population health initiatives to deliver and execute an appropriate ESG strategy.
ESG reporting – Many of the elements measured by The Joint Commission include data that could be helpful for ESG-related reporting. According to a survey featured in a recent Modern Healthcare article, 90% of CFOs say they have defined their ESG strategy or are in the process of doing so. Given all of the data requirements related to ESG strategic efforts that CFOs have outlined, along with rigorous reporting requirements, it will be critical that organizations establish robust data governance processes. In addition, it will be incumbent on organizations to support, maintain and evaluate the various environmental and community programs within their ESG platforms. Just saying you expect to reduce your carbon emissions, or increase the diversity of your board, is not going to be enough. Organizations will need to provide the data and support to stakeholders when asked.
Helpful guidelines, meaningful standards and metrics, a robust ESG strategy and smart data collection and assessment can all work in tandem with health care organizations as we strive for health equity. At the same time, organizations should look to use this key data and intelligence to fortify and measure other elements of the organization’s strategy and long-term planning.
Rick Kes is a health care senior analyst with RSM US LLP, and Danny Schmidt is a health care senior manager with RSM US LLP.