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AHIMA’s Position

AHIMA supports the use of public policy to reduce and eliminate health disparities and inequities, both in the face of the COVID-19 pandemic and in healthcare more broadly. Health information professionals have the knowledge and expertise to help inform ongoing public policy discussions. To meet the needs of diverse populations and reduce and eliminate health disparities and inequities, AHIMA believes that public policy must:

Encourage the standardized collection of accurate and complete patient demographic and social determinants of health data in ways that are culturally competent to better understand the communities being served and their related needs.

Guarantee the right for all to have access to affordable, high-quality health coverage, including addressing current coverage gaps to achieve comprehensive health coverage for all. This includes individuals with multiple chronic conditions, those experiencing challenges in access to care, and underinsured and uninsured individuals.

This includes promoting the development, piloting, and testing of machine learning and artificial intelligence technologies and solutions that identify and address biases in the data and avoid exacerbating existing health disparities and inequities. Building health equity into program and system design should also be considered.

This includes promoting delivery and finance models such as CMS’ CMMI Accountable Health Communities (AHC) Model that are designed to reward efforts to reduce health disparities and improve equity by addressing social determinants of health. Development and use of disparities-sensitive quality measures, including measures that assess whether interventions promote health equity, are also critical to reducing health disparities and inequities.

Including how to consistently and accurately collect, use, and maintain patients’ demographic information in ways that are culturally sensitive. Investment in a diverse, culturally competent professional workforce is also needed to foster an inclusive approach to addressing health disparities and inequities.

Including encouraging strong patient-provider relationships, creating opportunities for community leaders to be engaged and part of the decision-making process, identifying and dismantling policies that support structural racism and discrimination, and fostering a commitment to improving the patient experience of marginalized communities. 

Background

Health equity is the attainment of the highest level of health for all people. Health disparities are differences in health outcomes and their causes among groups of people. The underlying causes of health disparities are complex and involve social determinants of health, differential access to high-quality care, individual behavior, and biology. Today, communities including racial and ethnic minorities, sexual and gender minorities, individuals with disabilities and those living in rural areas experience a disproportionate share of acute or chronic diseases and adverse health outcomes compared to their non-minority counterparts. This disproportionality is reflective of the health inequities that exist in our healthcare system today.

Addressing health disparities is not only necessary to address health inequities but to improve overall quality of care, population health, and reduce costs. Studies suggest that disparities cost an estimated $93 billion in excess medical costs and $42 billion in lost productivity per year as well as economic losses due to premature deaths.

 

Key Points

Key challenges to reducing and eliminating health disparities and inequities include:

  • Lack of quality data on health disparities as a result of inaccurate, incomplete, and non-standardized demographic data and social determinants of health;
  • Lack of standardized processes and definitions for the collection of patient demographic data and social determinants of health;
  • Limited gains in health coverage due to recent changes in federal health policy;
  • Ongoing disparities in socioeconomic factors including but not limited to: income, education, health literacy, and housing;
  • Limited adoption and implementation of cultural competence techniques, including workforce education and training as well as a diverse and culturally competent workforce to empower healthcare professionals to work effectively in cross-cultural situations;
  • Technology limitations, including the inability to accurately capture demographic information and social determinants of health, as well as lack of infrastructure, such as broadband access in rural and urban areas, to support digital health technologies;
  • Limited understanding by healthcare professionals and patients as to why patient demographic data and social determinants of health are collected and used; and
  • Lack of trust due to history of mistreatment of disenfranchised minority populations. 

June 21, 2021

AHIMA Responds to OMB Equity RFI

AHIMA submitted a response to the Office of Management and Budget (OMB) Request for Information (RFI) on methods and leading practices for advancing equity.

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