Hospitals and health equity - Translating measurement into action

The U.S. health care system ranks last on measures of equity among similar high-income countries.1 Although policymakers and payers have increasingly looked to hospitals to help reduce inequities, there’s been less focus on their role in addressing health-related social needs (HRSNs). Such needs are related to food insecurity, housing instability, a lack of access to transportation, an inability to afford utility bills, and exposure to interpersonal violence, among other concerns. Despite the strong links between HRSNs and health outcomes, recent evidence suggests that only one quarter of U.S. hospitals screen for these five needs.

To address this issue, the Centers for Medicare and Medicaid Services (CMS) recently announced the adoption of three health-equity measures in the Hospital Inpatient Quality Reporting program. The first measure, which will be implemented for the 2023 reporting period, evaluates hospitals on five domains: commitment to health equity as a strategic priority, collection of sociodemographic and HRSN data, analysis of these data, adoption of quality-improvement activities focused on health disparities, and leadership engagement with equity efforts. The second and third measures will require that hospitals report the percentage of adult patients who are screened for the five HRSNs described above at the time of admission and the proportion who screen positive for these needs.