Health Equity

 

Health equity has emerged as a prominent focus within the public health field, reflecting a growing awareness of disparities and their impact on health. The Centers for Medicare & Medicaid Services (CMS) 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.”

In September 2024, CMS released an updated framework to further advance health equity, expand coverage, and improve health outcomes for the more than 170 million individuals supported by CMS programs.

CMS’s Updated Framework for Health Equity

• Priority 1: Expand the collection, reporting, and analysis of standardized data.
• Priority 2: Assess causes of disparities within CMS programs, and address inequities in policies and operations to close gaps.
• Priority 3: Build capacity of Health Care Organizations and the workforce to reduce health and health care disparities.
• Priority 4: Advance language access, health literacy, and the provision of culturally tailored services.
• Priority 5: Increase all forms of accessibility to health care services and coverage.

 

How Public Consulting Group (PCG) is Advancing Health Equity

PCG is increasingly incorporating a health equity perspective into our work, offering traditional stratification of data by age, race, ethnicity, and geography, as well as new categories suggested by the CMS framework, such as sexual orientation, gender identity, preferred language, disability status, and health related social needs. 

We are committed to providing strategies and resources to help entities understand and incorporate CMS’s updated framework into their work. 

• Priority 1: Expand the collection, reporting, and analysis of standardized data We develop internal and public-facing reports, presentations, and a Health Quality and Equity Dashboard, all of which may include stakeholder outreach that Executive Office of Health and Human Services (EOHHS) has conducted, as directed by EOHHS. Reports will be developed with Entity, EOHHS, and/or EOHHS vendor data and will include, but are not limited to:
  • Entity-Specific Reports: Provides a written overview of each Entity’s program performance and health equity administrative requirements in each performance year.
  • Annual Reports: Provides a written overview of all Entity program performance and health equity administrative requirement in each performance year.
• Priority 2: Assess causes of disparities within CMS programs, and address inequities in policies and operations to close gaps Work with EOHHS vendors and MassHealth subject matter experts (SMEs) to analyze processes within entities that impact care.
• Priority 3: Build capacity of Health Care Organizations and the workforce to reduce health and health care disparities. We facilitate improvements and/or re-submission of Accountable Care Organizations (ACOs), Managed Care Organizations (MCOs), and hospital submissions within 14 calendar days, to the extent feasible, of providing initial recommendations to EOHHS.
• Priority 4: Advance language access, health literacy, and the provision of culturally tailored services. PCG collaborates with EOHHS to develop tools (e.g., rubrics) to evaluate and assess language access and culturally tailored services.
• Priority 5: Increase all forms of accessibility to health care services and coverage. We support EOHHS to promote integrated, coordinated care and hold providers accountable for quality and total cost of care through budget and report reviews, report assessments, and tailored recommendations for course corrections. PCG provides technical assistance to ACOs, MCOs, and hospitals to improve accessibility to health care services. 

 

Opportunities for Growth

While we believe PCG is making great strides in the health equity space, we realize we have opportunities to grow, especially in CMS Priority 4. Our experience and relationships with SMEs, both internal and external, create the ideal environment to expand our scope of work and become a leader in health equity. There are several growing state programs and opportunities that our team has identified as potential targets for our future work.

1. States under the All-Payer Health Equity Approaches and Development (AHEAD) Model

   AHEAD is a state total cost of care (TCOC) model that seeks to drive state and regional health care transformation and multi-payer alignment, with the goal of improving the total health of a state population and lowering costs.

2. States participating in the Medicaid Health-Related Social Needs Implementation Learning Series

   This 12-month learning series, made possible through support from Kaiser Permanente through its National Community Benefit Fund at The East Bay Community Foundation, encourages peer-to-peer learning as states pursue health-related social need (HRSN) initiatives for Medicaid populations.

3. States with (or pursuing) Section 1115 demonstration waivers

   While PCG works on several projects for states with Section 1115 demonstration waivers, we will continue to pursue these project opportunities. One potential Section 1115 waiver opportunity is states pursuing a waiver for the Inmate Exclusion Policy. These waivers will increase health equity with justice-involved people and aim to reduce recidivism rates.

  

Staff Spotlight

 

Patricia Perazzelli, MPH – Data Justice & Equity SME

Ms. Perazzelli is an Associate Manager with PCG supporting projects focused on Medicaid Redesign, and health analytics. She has 15 years of experience in Medicaid data, and managed care transformation. Her most recent roles include, leading the managed care oversight data collection and analysis work for the state of Hawaii, design of the technical assistance marketplace serving enhanced care management and community support providers in California, and the analysis of health equity data for Massachusetts. She has previously overseen the development of alternative payment arrangements for behavioral health providers and the transition of behavioral health services into managed care in New York and provided subject matter expertise and strategic direction for a maternal and behavioral health focused pay for performance program in New Jersey. She has also provided direct Value Based Payment implementation support to hospitals and behavioral health community-based providers as a Practice Transformation Specialist for the National Council for Mental Wellbeing.

 

 

 

Alexis Upshaw, M.Ed – Health Equity

Ms. Upshaw is a Senior Consultant with PCG supporting projects focused on Health Policy and Program Evaluation.  Alexis currently is the program manager for the MassHealth Quality Equity Program where she leads the MassHealth project team and subject matter experts to ensure equitable and quality processes within existing Massachusetts health entities.  She has over 20 years' experience in K-12 education and over 10 years in equity work spanning across the education and public health industry. Over this span of time, Ms. Upshaw has engaged senior leadership to act as champions for health and racial equity, providing them with the necessary tools to integrate equity into organizational policies and decision-making. She has conducted comprehensive needs assessments across leadership and staff to identify areas of improvement in racial equity awareness and practices. This involved reviewing policies, surveys, focus groups, and one-on-one interviews to ensure that the training program addressed specific organizational needs.  Her most recent roles include leading the team of experts in the execution of a behavioral threat assessment (BTA) tool offered to K-12 districts across the country.  She led the team in successful implementation of the BTA product while managing proposal and contract development and execution.  She successfully collaborated with internal and external partners and clients to facilitate successful implementation of the product and facilitated the growth of future partnerships.