By Jalisa Clark and Nadia Stovicek

Last month, the Centers for Medicare & Medicaid Services (CMS) held the first ever CMS Health Equity Conference. The event, hosted on the historic Howard University campus, brought together stakeholders ranging from government officials and health care professionals to community groups and researchers to discuss initiatives aimed at reducing health inequities. In this blog, CHIR members who attended the inaugural conference provide an overview of the meeting—including a presentation by CHIR faculty member Christine Monahan—and its implications for current and future health equity initiatives.

Committing to Health Equity

The magnitude of the conference demonstrates CMS’s commitment to health equity. The two-day event hosted several hundred in-person attendees from across the country, and around 3,000 virtual attendees tuned in to listen to over two dozen presentations each day. Speakers at the cross-agency event included Dr. LaShawn McIver, Director of the CMS Office of Minority Health; Stephen Benjamin, Senior Advisor and Director of the White House Office of Public Engagement; Admiral Dr. Rachel Levine, Assistant Secretary for Health for the U.S. Department of Health and Human Services (HHS); and other HHS officials.

Following the Framework

CMS structured the conference around its recently updated “Framework for Health Equity for 2022–2032.” The framework outlines CMS’s approach to enhancing health equity over the next ten years for people who have been historically underserved due to their race, ethnicity, disability, sexual orientation, gender identity, socioeconomic status, geography, preferred language, or political status. Agency action items are divided into five priority areas: improving data collection, assessing disparities within CMS programs, supporting health care providers and organizations tackling health disparities, implementing culturally and linguistically appropriate language services, and improving navigation and use of CMS-supported benefits for people with disabilities. Each of the conference panels covered one or more of these priority areas.

Although each panel focused on improving health care access and outcomes, presentations covered a variety of initiatives. From private sector solutions to collecting sexual orientation and gender identity data, a poignant presentation on the federal government’s obligation to the health of American Indians and Alaska Natives, and research on racial disparities in Medicaid Home and Community-Based Services utilization, the conference highlighted the wide range of barriers to health care access, affordable health care, and quality health services faced by underrepresented Americans.

CHIR and the Washington Health Benefit Exchange Present on State-based Marketplaces and Language Access

As the U.S. continues to diversify, states operating Affordable Care Act (ACA) Marketplaces have a responsibility to meet the language service needs of the populations they serve. In a session titled “Promoting Health Literacy and Advancing Language Access within Marketplaces,” CHIR Assistant Research Professor Christine Monahan detailed how states are meeting this obligation by presenting her forthcoming issue brief from the Commonwealth Fund, co-authored by fellow CHIR faculty members Jalisa Clark and Nadia Stovicek. The issue brief reports on existing language access policies for state-based Marketplaces (SBMs), including whether states have written language access plans, SBM processes to collect language data, the extent of oral language assistance services offered by SBMs, and consumers’ access to written translations.

Monahan was joined by LeAnn Blanco, Health Equity Manager for the Washington Health Benefit Exchange (Exchange), who presented on the Exchange’s journey to providing quality language services to the state’s growing limited English proficiency (LEP) population. In 2012, Exchange staff realized the need for “cross departmental” organization of language services, leading to the formation of the Health Equity Technical Advisory Committee. The Committee has since set equity-related benchmarks for Washington Healthplanfinder (the Marketplace website) and Customer Support Center. In its language access plan, the Exchange outlines available written language services, policies to assist LEP individuals, and an explanation of how the Exchange collects metrics on needed language services. The Committee reassesses the language access plan every two years and creates policies to incorporate feedback and address complaints identified by Washingtonians with limited English proficiency. Washington’s ongoing commitment serves as an example of the systematic checkmarks state-based Marketplaces can implement to assure LEP individuals are able to enroll in and use their health insurance.

Conclusion

The CMS Health Equity Conference aimed to foster collaboration and the sharing of insights between stakeholders to promote an equitable and inclusive health care system. The conference emphasized the need to acknowledge the U.S.’s history of racism, sexism, and other forms of discrimination to improve the health of all Americans. With urgent health epidemics and ongoing challenges like the Black maternal health crisis and Medicaid Unwinding, the creation and implementation of policy solutions remain pressing. We look forward to CMS’s continued progress in working to reduce health inequities.