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June 6, 2024 –Last week, the Centers for Medicare & Medicaid Services (CMS) held the second annual CMS Health Equity Conference. The event drew several hundred in-person attendees, including my colleague Kayla Holgash, and thousands of virtual attendees. I’m bringing in Kayla to provide some insights on this major conference.
Like last year, the event was hosted by CMS’s Office of Minority Health (OMH). Attendees had the opportunity to hear about recent program developments and updates from CMS leaders, explore the latest health equity research from presentations and posters, discuss promising practices and creative solutions, collaborate on community engagement strategies and network with others on how to sustain health equity through action.
CMS and the rest of the Biden administration have made it clear that promoting health equity is one of their highest priorities. The agency defines health equity as “the attainment of the highest level of health for all people, where everyone has a fair and just opportunity to attain their optimal health regardless of race, ethnicity, disability, sexual orientation, gender identity, socioeconomic status, geography, preferred language, or other factors that affect access to care and health outcomes.” CMS released and recently revised a framework to further advance health equity, and there has been a health equity component or emphasis in every initiative and reg that the agency has issued (and trust us, there have been a lot of regs!)
During the conference, CMS Administrator Chiquita Brooks-LaSure highlighted the progress made in this administration (particularly this year) toward advancing equity and touted several health equity regulatory actions. For example, she talked about the Medicaid access reg (read our summary of that reg here), which expanded access to home- and community-based services and implemented maximum appointment waiting times in Medicaid and the Children’s Health Insurance Plan (CHIP).
As expected, the conference also featured discussions on maternal health, given recent regulatory focus on this issue. Interestingly, a couple months ago in the Fiscal Year 2025 Inpatient Prospective Payment System (IPPS) proposed reg, CMS announced its intention to propose a targeted obstetrical services condition of participation (CoP) for hospitals and other facilities to help address disparities in maternal health outcomes. CMS plans to propose the CoP in the Calendar Year 2025 Outpatient Prospective Payment System proposed reg (which will be released later this month or next) and sought comment in the IPPS proposed reg on what such a CoP should look like. The introduction of a CoP is one of the most powerful “tools in the toolbox” CMS can employ when the agency wants to address a specific issue.
During the conference itself, a major theme from the discussion around maternal health was the need to integrate mental health services into maternal healthcare. From 2017 to 2019, incidents and conditions related to mental health and substance use disorders were the leading cause of pregnancy-related deaths in the United States. Speakers from the Health Resources and Services Administration, the Substance Abuse and Mental Health Services Administration, and several other agencies and organizations discussed efforts to address this crisis. For example, several grants have been made available and the newly created Task Force on Maternal Mental Health released an equity-focused National Strategy to Improve Maternal Mental Health Care.
Various breakout sessions during the conference also focused on maternal health topics, including improving equity in Medicaid and CHIP maternal health, and achieving digital equity and literacy in maternal health. Digital solutions can improve access, outcomes and patient solutions, but as many as half of all patients are unable to use or access such tools, leading to disparities. Conference speakers urged stakeholders to work towards:
Another policy issue that came up during the conference related to the need to expand access to telehealth services for the treatment of individuals with disabilities. Stakeholders emphasized that people with disabilities must be included in the decision-making process to ensure that solutions meet their needs. Common telehealth-related challenges for people with disabilities include website and app accessibility and effective communication. Recent regulatory changes have expanded the legal rights related to telehealth for people with disabilities, but people with disabilities are not monolithic, and there are different communications needs for different people and different telehealth settings. The general consensus among conference participants was that CMS should use its funding and infrastructure to develop training materials in consultation with people with disabilities and subject matter experts.
All in all, the CMS Health Equity Conference tried to hit on all the ways the Biden administration has been trying to address social determinants of health, reduce disparities in care and promote health equity. Absent from the conference’s discussions, however, was what the future of health equity advocacy might look like, especially if the administration changes, or even in a second Biden term. Policy goals and priorities will likely shift depending on what happens in November, and stakeholders interested in health equity issues are eager to have a better understanding of the future policy landscape. While it is difficult to project what the policy landscape will look like next year (and whether there will be a third annual CMS Health Equity Conference), Biden administration officials, conference participants, and other stakeholders definitely feel that there is much more work to be done to reduce disparities in health outcomes.
Until next week, this is Jeffrey (and Kayla) saying, enjoy reading regs with your eggs.
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