Andy Slavitt Helps Launch New Health Equity Coalition

The former administrator of the Centers for Medicare & Medicaid Services wants the agency to make more progress in addressing health equity.

A group including health systems, a health plan, a healthcare analytics company, and the association representing Illinois community health centers has launched the Midwest Health Equity Coalition.

Health equity has emerged as a pressing issue in U.S. healthcare during the coronavirus pandemic. In particular, there have been COVID-19 healthcare disparities for many racial and ethnic groups that have been at higher risk of getting sick and experiencing relatively high mortality rates.

Two of the prime organizers of the Midwest Health Equity Coalition are Andy Slavitt, former administrator of the Centers for Medicare & Medicaid Services (CMS), and Eric Whitaker, MD, MPH, founder and executive chairman of Zing Health, a payer that features a Medicare Advantage health plan.

Slavitt has expressed frustration about the inability of CMS to address health equity when he was leading the agency, Whitaker says. "While they had a deep interest in addressing health equity under the Obama administration, there were few clinical models for addressing health equity and the ability of CMS to impact health equity was sorely lacking. That included clinical models that CMS could get behind for high-impact diseases and that included data collection."

The coalition is committed to reducing racial health disparities among underserved seniors in Illinois, Indiana, and Michigan.

The primary goal of the coalition is to do foundational work on health equity that leads to policy recommendations, Whitaker says. "By coming together with health systems, federally qualified health centers, payers, and healthcare associations, we wanted to put together the best thinking about health equity, so that we could make policy recommendations to CMS as well as demonstrate and recommend clinical models. We want to see what works."

The coalition held its first meeting last week and features six work groups: clinical, payment, data support, policy coordination, benefit design, and marketing and outreach.

The coalition will be focusing on health equity for one syndrome, Whitaker says.  "After consulting with our clinical work group, we decided to focus on metabolic syndrome, which is hypertension, diabetes, and hypercholesterolemia. When you look at seniors—particularly seniors of color—an overwhelming percentage of this population have those conditions. The thought is that if we can make some progress in this area, we would do a great service for the country."

The coalition will be gathering best practices for health equity, he says. "At our first meeting last week, we put together the first draft of a compendium of best practices from the coalition partners that is a living document that will be expanded over time as we identify work that is being done by coalition partners. As part of the compendium, we have done a literature review of best practices related to health equity. One of the things that is true about medicine in the United States is it can take almost two decades before something that is discovered in the lab or the community is rolled out for general consumption by populations that can benefit. We want to accelerate that process for health equity."

A potential health equity best practice that the coalition is looking at is continuous glucose monitoring for diabetic patients, Whitaker says. "At Zing Health, we are making these sensors available to our diabetic members at no cost. Right now, there are no other healthcare payers doing this, and it is not something that CMS is mandating. We are getting this out to our members, who are by and large in low-income communities of color. We are monitoring the impact it has on glucose control."

Collection of data is pivotal in Zing Health's continuous glucose monitoring initiative, he says. "We are going to end up having a data set of the impact of continuous glucose monitoring on blood sugar levels and be able to assess health outcomes. Then we will be able to recommend to CMS criteria if you were to have continuous glucose monitoring as one of the options for measuring blood sugar. We can do on-the-ground work with the institutions we are working with. We can have outcomes, and we can recommend policy as a result of the findings."

The coalition is hoping to have several positive impacts, Whitaker says. "I would be excited if the coalition can point to clinical models that have a good effect on the vulnerable populations we are targeting. I would be excited if we could be able to make policy recommendations to CMS that matter around health equity. I would also be happy if we shine a light on the existing work that is being done at our partner institutions. It would be ideal to find great models that are successful then replicate them across the country."

Related: How to Create an Equity Measure in 5 Steps