Crosswalk of AHA Health Equity Roadmap with Selected National Health Equity Quality Measures and Standards for Hospitals and Health Systems
Introduction
The American Hospital Association’s (AHA) vision is of a just society of healthy communities where all individuals reach their highest potential for health. Through the work of the AHA Institute for Diversity and Health Equity (IFDHE), the AHA provides tools, resources and practices to help hospitals and health systems advance their work on health equity, diversity and inclusion. In 2022, the AHA launched the Health Equity Roadmap, a framework to help members chart their own path toward advancing health equity and becoming more inclusive and diverse organizations.
Concurrently, policymaker interest in accelerating progress on health equity has grown, resulting in new mandatory regulations and requirements that require hospitals to adopt practices, or to collect and report certain health equity-related data. For its part, the Centers for Medicare & Medicaid Services (CMS) has adopted three new quality measures in its Inpatient Quality Reporting (IQR) program. One of the measures — Hospital Commitment to Health Equity — is required starting with the calendar year (CY) 2023 reporting year. The other two measures — Hospital Screening for the Social Drivers of Health — will be required starting in 2024. In addition, starting on Jan. 1, 2023, hospitals accredited by The Joint Commission are required to comply with a new set of standards intended to improve health equity and reduce health care disparities.
AHA members have expressed interest in understanding the degree of alignment between the AHA’s Health Equity Roadmap and these emerging regulatory policies, as well as the alignment among regulatory policies. The attached crosswalk identifies how each framework aligns with eight overarching key practices that are linked to advancing health equity in hospitals:
- Organizational prioritization and plan for health equity
- Senior leadership and board engagement, oversight and accountability
- Community engagement and collaboration
- Health equity/social drivers data collection
- Health equity/social drivers data use, analysis and tracking culturally and linguistically sensitive and equitable care delivery policies
- Workforce-focused health equity efforts
- Health equity-focused care improvement/disparities reduction
What This Crosswalk Shows
While hospitals must still meet CMS and Joint Commission requirements in the form and manner that they specify, the AHA’s Health Equity Roadmap closely aligns with these requirements. As a result, engaging with the AHA Health Equity Roadmap would be synergistic for many hospitals as they seek to both meet these requirements and accelerate their health equity work. Indeed, the AHA Health Equity Roadmap and CMS Commitment to Health Equity measure cover all eight practice areas. The Joint Commission standards cover seven out of the eight areas. At the same time, there are some differences in topics covered and the practices receiving the most emphasis. The AHA roadmap provides numerous examples of tools and practices that hospitals could implement that would help them potentially meet CMS or Joint Commission requirements.
AHA member hospitals have access to a diagnostic assessment (The Health Equity Transformation Assessment) from which to articulate their position on the Six Levers of Transformation. The AHA’s Transformation Action Planners — which are available to organizations that complete the AHA Equity Roadmap’s Health Equity Transformation Assessment — can help hospitals identify activities that also demonstrate compliance with some of the regulatory requirements. The Transformation Action Planners require hospitals to convene internal teams to develop action plans for each lever and to mobilize across the equity continuum.
Additional Resources
- AHA Health Equity Resource Series
- AHA FY 2023 Inpatient Prospective Payment System Final Rule Advisory that includes discussion of the three CMS measures: https://www.aha.org/advisory/2022-08-24-inpatient-pps-final-rule-fy-2023
- CMS IQR Measure Specifications/Guidance
- Hospital Commitment to Health Equity: https://qualitynet.cms.gov/files/63a0a19a76962e0016ad92f2?filename=AttstGuide_CmmtHlthEqStrctMeas.pdf
- Hospital Screening for the Social Drivers of Health: https://qualitynet.cms.gov/files/639a2e32fb845c00175c7ca1?filename=FY_2023_ScrnSocDrvrs_Scrn_PosSpecs.pdf
- Joint Commission R3 Report on New Health Equity Standards: https://www.jointcommission.org/-/media/tjc/documents/standards/r3-reports/r3_disparities_july2022-6-20-2022.pdf
Glossary of Key Terms/Abbreviations Used in Crosswalk
CMS = Centers for Medicare & Medicaid Services
IQR = Inpatient Quality Reporting, a measurement program of CMS
HRSN = Health-related social need
LD = Leadership (a chapter of Joint Commission’s standards for accreditation)
EP = Element of Performance (the specific ways hospitals must demonstrate compliance with a Joint Commission standard that forms the basis of hospital surveys)
