Centers for Medicare & Medicaid Services (CMS) released the Technical Expert Panel (TEP) Report on Health Equity (HE) Measurement for Home Health and Hospice on May 25. In last year’s rule making cycle, CMS proposed the development of a Structural Health Equity Measure for both settings, requesting feedback from providers and stakeholders. In the fall of 2022, CMS convened a TEP to review the proposed measure and provide feedback. The key takeaways from the TEP include:
- In Domain 1, Equity as a Key Organizational Priority: TEP element revisions reflect suggestions to ensure that the equity-focused priorities of organizations reflect the needs of the communities they serve.
- In Domain 2, Training for Health Equity: Revisions included providing examples to organizations on appropriate ways to substantiate that they provided training and learning opportunities.
- In Domain 3, Organizational Culture of Equity: Major element revisions reflect expansion to include all workforce development efforts (as opposed to just hiring) and to consider a broader range of “equity-focused factors” in such efforts, beyond solely hiring for diversity.
- Confidential Feedback Reports: TEP members proposed that such reports for HE should include the purposeful selection of data to effectively monitor and assess health equity. The TEP generally agreed that such a report would need to include a more clearly defined purpose and that providers would need to be educated on how to access and utilize the information in the report. Further, TEP members overall agreed that the report should remain confidential for the time being.
Additional Feedback from the TEP:
- Alternative suggestions were offered for both quality measures (e.g., number of nursing minutes) and stratification variables (e.g., SDOH items, race/ethnicity) that may be more appropriate for monitoring health equity.
- TEP discussions regarding additional approaches to measure equity in access to services, included the importance of capturing information about patients who were not served and why they were not served.
- TEP members emphasized organizational transparency, advising to collect and report demographic data of the patient population that providers and organizations serve.
- TEP members highlighted the importance of data collection directly from patients rather than caregivers whenever possible.
- Throughout the TEP’s discussion, they referred to equity-related resources that they use in their practices. These resources may be useful to organizations and providers who are looking to integrate equity into their organizational culture. Appendix B lists each resource along with a brief description and source.
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