OBJECTIVES:

Health equity has been defined as attainment of the highest level of health for all people, regardless of race, ethnicity, disability, and/or other factors affecting access to care and health outcomes in healthcare delivery. Health equity is becoming a priority for payers and hospitals looking to improve patient outcomes. The objective of this research was to evaluate health equity frameworks currently used by payer and hospital organizations.

METHODS:

Targeted literature searches were conducted in PubMed and Google Scholar to identify papers evaluating health equity frameworks. Searches were supplemented with information from payer and hospital organizations, including annual reports, frameworks, and guidelines. Key search terms included, but were not limited to, “diversity,” “health equity,” “guidelines,” and other similar terms.

RESULTS:

Across identified sources, equitable policies at the organizational level and provision of culturally appropriate patient care were key trends. The Centers for Medicare & Medicaid Services (CMS) developed a framework for health equity focusing on active measures at the system and community levels and identified five priority metrics to evaluate program performance. Cigna developed guidelines focused on internal actions, including working with community partners for case management, policy reviews to ensure equitable practices, and incorporating health equity into reimbursement models. To support the advancement of health outcomes and reduction in barriers to care, the American Hospital Association developed an equity roadmap based on six pillars designed to establish community collaboration, systematic and shared accountability, and equitable organizational policies.

CONCLUSIONS:

Health equity is a key objective for healthcare systems in the United States and has been increasingly incorporated into frameworks within healthcare delivery organizations. Existing frameworks serve as reference points for all payers, hospitals, and other entities developing future guidelines. Further research is required to assess if framework implementation is advancing health equity, including the impact on real-world patient outcomes.