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Making Healthcare Equity Actionable
The Joint Commission’s (JC) newly minted Health Care Equity Certification Program both recognizes and provides guardrails for accredited organizations developing healthcare equity initiatives. This voluntary certification program, effective July 1st, represents the Joint Commission’s increasing prioritization of healthcare equity as a critical patient safety issue requiring targeted standards of care. By distinguishing organizations with formalized, actionable plans and processes, this certification program takes a meaningful step towards addressing health-related social needs (HRSN) among patients.
Over the past two years, the JC has been gradually elevating the importance of healthcare equity in their assessment of organizations. Framing healthcare equity as a quality-of-care problem, rather than a tangential social justice matter, has laid the foundation for such initiatives. In December 2022, the healthcare equity-focused standard, LD.04.03.08, was reprioritized as a National Patient Safety Goal, NPSG16.01.01. By requiring accredited organizations to start developing the infrastructure needed to pilot and assess various healthcare equity programs, this standard lays the foundation for future work. Importantly, while the actual parameters of the standard remain the same, this reprioritization draws greater attention to the urgent need to address the persistent disparities permeating our healthcare system. The standard will continue to apply to JC-accredited hospitals and some ambulatory centers and behavioral health and human services organizations.
Reflecting this elevated focus, the JC established a resource center to help organizations achieve the requirements. These include identifying an individual to lead healthcare equity-related activities, using a representative sample to determine which HSRNs—from access to transportation, to education and literacy, to food and housing insecurity—are disproportionately affecting their patients, and analyzing quality and safety data to identify population-related disparities in healthcare experiences and outcomes. For example, organizations could analyze whether patients from certain sociodemographic backgrounds are reporting less-favorable experiences of care. From this foundational assessment of the disparities affecting their patients, organizations will then develop an action plan that addresses at least one of the identified areas. Importantly, organizations are also tasked to develop monitoring processes that evaluate the ongoing progress and success, or lack thereof, of the program. Recognizing that healthcare equity-related best practices have not yet been solidified across the industry, this resource center includes a repository of pilot programs that have been tested at accredited organizations.
The recently launched Health Care Equity Certification builds upon the precedents set by this standard, recognizing organizations with continued, and actionable, prioritization of healthcare equity. As such, the JC has created an additional resource center with strategies and program spotlights to help those pursuing the certification. While helping to standardize processes related to health equity, “achieving the certification may also help differentiate your organization to payers, employers, and government agencies,” as noted on the JC’s website. Given the increased attention to social determinants of health (SDoH) in value-based care initiatives—for example, social risk adjustment—this certification could meaningfully establish the infrastructure for organizations to integrate healthcare equity-related outcomes with traditional health outcomes. By translating grandiose visions into trackable insights, organizations can move towards negotiating value-based contracts that advance healthcare equity through benchmarking and adjustment strategies.