J Healthc Qual. 2022;44(5):276-285. doi: 10.1097/JHQ.0000000000000356.
The Accountable Health Communities model (AHC) was developed to test whether systematically screening for health-related social needs and referrals to community-based organizations to resolve unmet needs would affect healthcare use and costs for CMS beneficiaries. Purpose: The AHC model required applicants to develop Disparities Impact Statements (DIS), to increase the model's potential impact on health equity.
Authors conducted a thematic analysis of awardees' DISs to identify minority and underserved populations of focus, and the strategies awardees used to increase equitable participation in the model by minority and underserved populations.
Most awardees focused on multiple minority and underserved populations and used multipronged innovative strategies to pursue equity goals.
Considering recent health equity advancements as Executive Order 13985 and the release of CMS Innovation Center's Strategy Refresh, with highlights of health equity best practices from the AHC model, assessing use of DISs in the AHC model provides valuable lessons. Implications: Given HHS' broadscale promotion of DISs adoption as a viable quality improvement approach to achieving health equity, disseminating how the tool was used by a myriad of organizational types in the AHC model is critically important to improving future efforts to increase equity.
负责任的健康社区模式(AHC)旨在测试系统地筛查与健康相关的社会需求,并将其转介给社区组织以解决未满足的需求,是否会影响 CMS 受益人的医疗保健使用和成本。目的:AHC 模式要求申请人制定差异影响声明(DIS),以增加该模式对健康公平的潜在影响。
作者对获奖者的 DIS 进行了主题分析,以确定关注的少数民族和服务不足人群,以及获奖者为增加少数民族和服务不足人群对该模式的公平参与而采用的策略。
大多数获奖者关注多个少数民族和服务不足的人群,并采用多管齐下的创新策略来追求公平目标。
考虑到最近在健康公平方面的进展,如行政命令 13985 和 CMS 创新中心战略更新的发布,突出了 AHC 模式的健康公平最佳实践,评估 AHC 模式中使用 DIS 的情况提供了有价值的经验教训。意义:鉴于 HHS 广泛提倡采用 DIS 作为实现健康公平的可行质量改进方法,传播 AHC 模式中各种组织类型如何使用该工具对于改进未来增加公平的努力至关重要。