Health Equity: An Emerging New Reality Among America’ s Hospitals

Health Equity: An Emerging New Reality Among America’ s Hospitals

Last week, the chief medical officer (CMO) for the Centers for Medicare & Medicaid Services (CMS), Dora Hughes, MD, MPH, published a blog in Health Affairs Forefront, calling out the progress since the October 2021 of the release of the 2030 vision from the CMS Innovation Center, “A health system that achieves outcomes through high quality, affordable, and person-centered care.” (Hughes, D., 2023).

The blog posting discussed the progress that has been made thus far, however I think it will be relevant for today’s discussion to cover what has and is still expected for 2023.

Thus far we have seen the release and refinement of the health-related social needs (HRSN) screening with additional toolkit information for implementation.  In addition, I have reported on the release of the fiscal year (FY) 2024 proposed rule for the Inpatient Patient Prospective Payment System (IPPS) initiatives related to health equity, specifically the social drivers of health initiative and additional quality bonusing for hospitals with high proportions of Medicaid-Medicare patients.

CMS states they are committed to continue the support for safety-net providers by evaluating and building future model designs that encourage care for Medicaid beneficiaries.

In the article, Dr. Hughes provides a high-level picture of the forthcoming initiatives from the CMS Innovation Center including the following:

  • Identifying and expanding the opportunities for care delivery to people with disabilities;
  • Investing more in rural health, particularly geographically isolated communities;
  • Exploring social risk adjustment factors for payment which may include measures such as frailty, eligibility for the Part D Low Income subsidy, and life expectancy;
  • Methods to help address high-cost drugs, and increase access to life-changing drug therapies. Specifically called out was the Cell and Gene Therapy Access Model. This initiative also calls for a generic drug maximum copayment of $2 a month for Medicare beneficiaries; and,
  • A method to identify implicit bias in CMS initiatives to avoid the further perpetuation of inequality.

I think we have seen in recent weeks a shift in the air as many hospitals are laying off personal as they combat the financial woes of the healthcare industry.  This news will likely continue for health systems as we continue in our collision with a new wave of healthcare in which social complexity is acknowledged and financially rewarded in a value-based structure that is clashing with the Medicare fee for service (FFS) models of today.

Reference:

Advancing Health Equity Through The CMS Innovation Center: First Year Progress And What’s To Come | Health Affairs

Facebook
Twitter
LinkedIn

Tiffany Ferguson, LMSW, CMAC, ACM

Tiffany Ferguson is CEO of Phoenix Medical Management, Inc., the care management company. Tiffany serves on the ACPA Observation Subcommittee. Tiffany is a contributor to RACmonitor, Case Management Monthly, and commentator for Finally Friday. After practicing as a hospital social worker, she went on to serve as Director of Case Management and quickly assumed responsibilities in system level leadership roles for Health and Care Management and c-level responsibility for a large employed medical group. Tiffany received her MSW at UCLA. She is a licensed social worker, ACM, and CMAC certified.

Related Stories

Leave a Reply

Please log in to your account to comment on this article.

Featured Webcasts

2026 IPPS Masterclass 3: Master MS-DRG Shifts and NTAPs

2026 IPPS Masterclass Day 3: MS-DRG Shifts and NTAPs

This third session in our 2026 IPPS Masterclass will feature a review of FY26 changes to the MS-DRG methodology and new technology add-on payments (NTAPs), presented by nationally recognized ICD-10 coding expert Christine Geiger, MA, RHIA, CCS, CRC, with bonus insights and analysis from Dr. James Kennedy.

August 14, 2025
2026 IPPS Masterclass Day 2: Master ICD-10-PCS Changes

2026 IPPS Masterclass Day 2: Master ICD-10-PCS Changes

This second session in our 2026 IPPS Masterclass will feature a review the FY26 changes to ICD-10-PCS codes. This information will be presented by nationally recognized ICD-10 coding expert Christine Geiger, MA, RHIA, CCS, CRC, with bonus insights and analysis from Dr. James Kennedy.

August 13, 2025
2026 IPPS Masterclass 1: Master ICD-10-CM Changes

2026 IPPS Masterclass Day 1: Master ICD-10-CM Changes

This first session in our 2026 IPPS Masterclass will feature an in-depth explanation of FY26 changes to ICD-10-CM codes and guidelines, CCs/MCCs, and revisions to the MCE, presented by presented by nationally recognized ICD-10 coding expert Christine Geiger, MA, RHIA, CCS, CRC, with bonus insights and analysis from Dr. James Kennedy.

August 12, 2025

Trending News

Featured Webcasts

The Two-Midnight Rule: New Challenges, Proven Strategies

The Two-Midnight Rule: New Challenges, Proven Strategies

RACmonitor is proud to welcome back Dr. Ronald Hirsch, one of his most requested webcasts. In this highly anticipated session, Dr. Hirsch will break down the complex Two Midnight Rule Medicare regulations, translating them into clear, actionable guidance. He’ll walk you through the basics of the rule, offer expert interpretation, and apply the rule to real-world clinical scenarios—so you leave with greater clarity, confidence, and the tools to ensure compliance.

June 19, 2025
Open Door Forum Webcast Series

Open Door Forum Webcast Series

Bring your questions and join the conversation during this open forum series, live every Wednesday at 10 a.m. EST from June 11–July 30. Hosted by Chuck Buck, these fast-paced 30-minute sessions connect you directly with top healthcare experts tackling today’s most urgent compliance and policy issues.

June 11, 2025
Open Door Forum: The Changing Face of Addiction: Coding, Compliance & Care

Open Door Forum: The Changing Face of Addiction: Coding, Compliance & Care

Substance abuse is everywhere. It’s a complicated diagnosis with wide-ranging implications well beyond acute care. The face of addiction continues to change so it’s important to remember not just the addict but the spectrum of extended victims and the other social determinants and legal ramifications. Join John K. Hall, MD, JD, MBA, FCLM, FRCPC, for a critical Q&A on navigating substance abuse in 2025.  Register today and be a part of the conversation!

July 16, 2025

Trending News

Prepare for the 2025 CMS IPPS Final Rule with ICD10monitor’s IPPSPalooza! Click HERE to learn more

Get 15% OFF on all educational webcasts at ICD10monitor with code JULYFOURTH24 until July 4, 2024—start learning today!

CYBER WEEK IS HERE! Don’t miss your chance to get 20% off now until Dec. 2 with code CYBER24