“The CMS inspector report gave us a framework for how CMS will utilize its data in a variety of facets,” said Kamala Green, social drivers of health program...
Data is driving many of the federal government’s initiatives around equity, including health care. The Centers for Medicare and Medicaid Services, for example, is working to identify gaps in care and develop interventions to address them by focusing on stronger data collection and intersectional analyses for populations defined by race, ethnicity, language, geography and disability.
In the past, the government’s approach has been limited to simply providing funding to a community, which is not sustainable. Instead, agencies should understand social drivers of health equity, which include factors like education, economics, mental health, environmental safety and food access. By collecting and analyzing data regarding the social drivers of health equity, agencies can lay a foundation allowing for the best decisions about providing effective health care to vulnerable communities.
Earlier in the summer, the CMS inspector general recommended CMS focus on how data is standardized and used to make better informed decisions. That data will focus on demographics and populations through a geographic lens, which will grant visibility into understanding how and why certain populations are underserved.
“The CMS inspector report gave us a framework for how CMS will utilize its data in a variety of facets,” said Kamala Green, social drivers of health program manager at National Government Services. “It served as a much-needed switch – a real shift in focus when we take a look at how to use data.”
Kamala said the data will lead to effective allocation of resources to help solve community issues, and to develop metrics to gauge progress. Prior to the COVID-19 pandemic, there was a general understanding of public health issues, but the deeper understanding of how issues are connected was lacking.
For example, diabetes was a prominent issue and top priority before the pandemic. There was plenty of data on it, and providers understood how to treat it. But now, COVID-19 increases a person’s chances of developing diabetes. That changes the data, but also provides an opportunity to collect more data on prevention of chronic diseases.
“We need to collect more data centralized and focused on prevention,” Green said. “When we examine a person’s health, we look beyond a chronic disease management perspective to get a holistic picture, taking into account the other health and social related needs that impact health. That’s the data we need to collect.”
With that data in-hand, we can understand which communities were underserved, how, and what resources they need to achieve health equity. The final step for CMS and other federal health agencies is determining how to achieve that goal, and measuring the success of their efforts.
Historically, data management has influenced policy. Agencies viewed data about a region or community, and then made a decision regarding the distribution of resources to inform policy. But the current administration flipped that script; choosing health equity as a policy, and letting it inform data management.
The first step was a discussion on how to achieve equity. The second step is improving data collection and standardization, which is why agencies need to evaluate their focus around health equity: What specifically are they trying to address or accomplish? They must evaluate their current health equity and outcomes data, and determine if they have the right information. If not, they should examine their data collection processes to get to that point. Only then will they be able to determine if their existing policies adequately address health disparities.
In addition to analyzing data collection strategies, Green called for a national health equity strategy.
“Once we have a national strategy, the state and local organizations that directly impact health can build on that strategy and inform the industry about what works in the strategy,’” she said. “My hope is that as this administration continues, we start to see work on creating a national health equity, because inequity is not going away.”
Administrations change, so a guiding strategy for all stakeholders and partners can help them continue to push forward toward achieving health equity. For example, National Government Services spent this summer developing an application that will help focus on how to deploy resources with an eye toward chronic disease management.
“We look forward to utilizing the platform to generate ideas that enable us to further inform and advance health equity,” Green said. “As a key stakeholder in this work, each of us should examine how we’ll operate from a social responsibility, internal operations and business perspective. We should inform our social responsibility efforts by viewing that data and applying it both internally and externally.”
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