NCQA Pilot Program Making A Health Equity Impact

Making an Impact on Health Equity with the New NCQA Pilot Program

The health and well-being of a population are inextricably linked to the opportunities people have in which to prosper. The environments we inhabit, and the forces and factors we experience, may inherently serve to widen disparities among individuals. This makes a focus on health equity crucial for the success of healthcare providers and payers, and healthier individuals and communities.

New health equity program from the NCQA

The National Committee for Quality Assurance (NCQA) has long based standards for the organization’s accreditation reviews on clinical performance and consumer experience. Healthcare providers and payers use the standards as a framework for executing health equity gap analyses and aligning improvement activities with areas in need of attention.

A new pilot, announced December 2021, establishes the Health Equity Accreditation Plus evaluation program. The program is designed to help healthcare organizations build processes and cross-sector partnerships to identify and address social risk factors in the respective communities of operation and in accordance with the social needs of the individuals served.

We can partner with your organization to explore the implications the new health equity standards present for your organization. Below are key points of the new health equity program standards, as documented in the Overview of Proposed Standards Health Equity Accreditation Plus. Health Advance is well-suited to add value holistically or by targeting specific opportunities.

RTI Health Advance can help in the following key areas of the NCQA health equity pilot program.

Health Equity Plus 1: Program Description

The organization engages the community where it operates and the individuals it serves to identify the most effective ways to reduce the negative effects of social risks in the community and offer services that address individuals’ social needs.

Element C: Health Equity Program Evaluation

The organization performs an annual written evaluation of the program to address social risks and needs. The evaluation includes:

• A description of completed and ongoing activities
• Trending of measures (every three years) to assess the performance of activities implement to reduce negative health effects resulting from the social risks faced by community members
• Trending of measures to annually assess the performance of activities that address the social needs of individuals
• Annual collection of feedback provided by program stakeholders
• Analysis of results (every three years), including analysis of barriers to improvement
• Review and interpretation of results by community representatives and of the individuals served by the organization

Health Equity Plus 2: Collection, Integration, and Analysis of Community and Individual Data

The organization uses community and individual-level data to inform the design of its social risks and needs program. It identifies needed resources and partnerships to address community social risks and individual social needs.

Element A: Community-Level Social Risk Data Integration

Every three years, the organization integrates community-level social risk data from:

• A community health assessment is performed by a local public health agency or equivalent
• A second source is endorsed by at least one of the organization’s partners
• A third source

Element B: Collection of Individual-Level Social Needs Data

The organization demonstrates its framework for collecting data on individuals’ unmet social needs includes a method for directly assessing:

• Financial insecurity
• Food insecurity
• Housing stability
• Access to transportation
• Interpersonal safety
• Barriers to accessing healthcare, including experiences with discrimination, bias, or racism, or access to technology-based services

Health Equity Plus 5: Referrals, Outcomes, and Impact

The organization refers individuals to social needs resources, closes the loop to track progress, and evaluates the effectiveness of the referral process.

Element D: Bidirectional Partnership Evaluation

The organization and its partners collaborate annually to evaluate the effectiveness of the partnership based on:

• The overall experience of individuals in the population it services when accessing/receiving resources and interventions
• The experience of individuals in the population it serves with discrimination or bias when accessing/receiving resources and interventions
• The status of referrals, as tracked in HE Plus 5, Element B
• Disparities in referral status, as analyzed in HE Plus 5

Element C.

• Bidirectional feedback on the partnership process

Advance health equity with Health Advance

What’s the best path forward for your organization? As professionals committed to advancing the health of society at large, Health Advance supports programs driving significant improvements to identify, assess, and inform measures setting higher standards and more equitable policy.

Our team of health equity experts has the storied experience to knowledgeably guide you through the implications and opportunities presented by the new Health Equity Accreditation Plus program standards. Learn more about health equity solutions from RTI Health Advance.

Use the contact form to get in touch today.