IHI Leaders Expect Significant Progress on Health Equity in 2022

“There is new leadership at the National Quality Forum, with Dana Safran at the helm there. She is a patient-centered outcomes researcher. You are going to see a lot more movement toward outcome-focused measurement, and part of that will be about guidance around outcomes stratification using race, ethnicity, language, disability, sexual orientation, and gender identification. There will be guidance around how to stratify measures of outcomes on those dimensions,” he said.

Stratification of health equity data likely will be a key trend in 2022, Mate said.

“With outcome-based measurement in hand, we are also going to see organizations such as the National Committee for Quality Assurance inviting healthcare organizations to start stratifying their data. So, we are going to have outcome measurement, more stratification, and encouragement from organizations that manage large measure sets such as the HEDIS measures at NCQA to use those standard definitions of what outcomes look like and how they should be stratified so that we are looking at data in a more stratified manner,” he said.

There likely will be more public reporting of health equity data in 2022, Mate said. “You will see more public reporting of stratified measures particularly around race and ethnicity. We are already beginning to see that. You are going to see more health plans and other organizations publish that data going forward.”

Mate expects modest progress on health equity incentives in 2022.

“I don’t think we will see incentives to remediate inequities. What we will see is economic incentives to collect the data and report the data in a more transparent fashion over the next year. Two to three years out from now, we will start to see incentives from payers to provider organizations not only to collect the data but also to reward health systems for having made meaningful progress on remediating specific inequities,” he said.

Berwick said federal legislation bodes well for health equity in 2022.

“The legislation that has passed in Congress and the pending Build Back Better bill have embedded in them the biggest potential progress on health equity this country has seen since the 1960s. So, a lot of the progress on health equity depends on whether Congress will end up supporting the Build Back Better bill, which has levers for health equity embedded in it. Already, we have the infrastructure bill, which has a lot in it. If these pieces of legislation are properly executed, it should be helpful,” he said.

Officials in the Biden administration appear to be committed to tackling health equity, Berwick said.

“In conversations with Biden administration officials, I don’t think I have had a single conversation with anyone in this administration that has not included—and often led with—the pursuit of health equity as a priority. President Biden is walking the talk on health equity. The optimist in me wants to say that we will be seeing progress. … I am excited by the policy initiatives we are seeing coming out of this administration,” he said.