Health Equity

• HPC research publications  elevate topics that call out disparities and inequities in the health care system. 
• The Annual Health Care Cost Trends Report highlights issues of equity, including a chartpack incorporating data on community income and race/ethnicity and a dashboard measuring performance on health equity and affordability metrics. 
• The Health Equity Practice and Style Guide is a practical resource developed by and for HPC staff to promote intentional and consistent use of language and terminology across all agency work products. The Guide is a living document, updated by a staff committee and released annually.
• The HPC integrates the best available data on race and ethnicity (or proxy data when necessary) into analyses, including linking discharge data with the APCD to examine differences in spending by race/ethnicity.
• The HPC is developing an affordability index model that measures differential impacts of premiums and out-of-pocket spending by factors like income, geography, and market segment, as part of the broader push toward affordability standards in the Commonwealth. 

• The “equity in everything” approach extends into discussions during HPC public meetings, including utilizing the Health Care Cost Trends Hearings as an opportunity to bring increased attention and transparency to health equity. 
• The HPC hosts investment program awardees at HPC public meetings to inform HPC commissioners on impact of equity-focused initiatives (e.g., MassUp, C4SEN, BESIDE) and convenes awardees to elevate equity topics, e.g., a Patient Experience Committee of Black doulas and Black birthing people to advise on key themes and evaluation design of the BESIDE program.
• The HPC Advisory Council helps to inform and enhance the HPC’s policy agenda and priorities, including its health equity work. New members are appointed bi-annually, broadening and diversifying membership to encompass more perspectives and experiences within the health care system. A current list of Advisory Council membership can be found here.

• The HPC has expanded the focus on maternal health equity through the BESIDE and HEART-BP investment programs. HEART-BP will fund initiatives to address existing inequities in severe maternal morbidity driven by hypertensive disorders in pregnancy. In partnership with BESIDE awardees, more than 70 babies have been born through racially concordant doula services for Black birthing people. 
• The HPC aligns efforts with and support the work of the Executive Office for Health and Human Services’ Advancing Health Equity in Massachusetts (AHEM) initiative, including recent work coordinating with backbone organizations to find funding for place-based investments; development of metrics for inclusion in dashboards for AHEM’s focus communities; and, advising on priority areas of intervention such as health-related social needs screening (HRSN), reimbursement for certified nurse midwives (CNMs), birth center regulations, and the remote-blood pressure monitoring pilots underway across the state.
• The HPC continues to advance health equity through Accountable Care Organization (ACO) Certification standards, certifying 14 ACOs in 2023-2024 under an updated Health Equity Requirement that pertains to: data-driven interventions; patient engagement initiatives, and strategic planning. 
• The HPC helps fund and provide staff support to the Executive Office of Health and Human Services’ Quality Measure Alignment Taskforce. Part of this support includes developing standards for race, ethnicity, language, and disability status and sex, sexual orientation, and gender identity data collection and accountability. 
• The HPC engaged in a partnership with the Department of Public Health to administer funding from the State’s Opioid Response in support of projects aimed at addressing inequities in access to medications for opioid use disorder (MOUD) for birthing people with OUD.

• In reviews of market changes, the HPC incorporates patient characteristics (e.g., race/ethnicity, geography, insurance types), potential impacts on affordability and accessibility, and parties’ plans for improving equitable access to care. 
• During the performance improvement plan (PIP) process, the HPC recognizes and assesses an entity’s baseline position in the market and specific historic trends. The HPC considers where spending increases may be attributed to necessary investments in care for underserved populations or market corrections to address historic disparities in pricing. 
• The HPC assesses the nature and impacts of private equity and other for-profit investors often acquiring or funding health care entities that serve older adults and MassHealth members, recommending options for better monitoring and guarding against potential negative outcomes of their involvement.

The Health Equity Compact. The Health Equity Compact (the “Compact”) is group of over 65 leaders of color who aim to advance health equity together in Massachusetts. Compact members are high-level executives and experts from a diverse set of health, business, labor, and philanthropic organizations, including hospitals, health centers, payers, academic institutions, and public health. Its members are committed to eliminating health inequities as the next chapter of health reform. The Compact hosts an annual event and convening of influential leaders from government, health, business, and other diverse sectors who are key to advancing health equity statewide. 

Blue Cross Blue Shield of MA Foundation (BCBSMAF). The BCBSMAF has partnered with leading community organizations focused on health equity to translate ideas into action to promote racial justice and equity in health. In 2023, the Foundation published a studyaiming to quantify the economic burden of racial and ethnic disparities in health care access, quality, and outcomes, as well as a statewide Health Equity Action Plan, which proposed a vision and framework for achieving a racially and ethnically equitable health care delivery system in Massachusetts. This was followed by the Massachusetts Health Equity Initiative Inventory, which contains over 140 interventions and programs being implemented in the state. 

Boston University Center for Antiracist Research: Racial Data Lab. The Boston University Center for Antiracist Research represents a collaborative research and education effort across multiple disciplines to build a world where racial equity and social justice prevail. The Center’s COVID Racial Data Tracker (CRDT), in collaboration with the COVID Tracking Project, advocated for, collected, published, and analyzed racial data on the pandemic across the United States. The CRDT was, while active, the most complete race and ethnicity data repository on COVID-19 in the country. The CRDT data and information remains publicly accessible.

Massachusetts Taxpayer Foundation (MTF): “Closing the Racial Divide in the U.S. and Massachusetts: A Baseline Analysis.”  This 2021 report from MTF statistically documents inequities in wealth, income and employment, education, criminal justice, health care, as well as the potential economic and fiscal gains that could be realized by closing the racial gap.

Massachusetts Legislature Health Equity Task Force: "A Blueprint for Health Equity." This report was presented to the Massachusetts Legislature in July 2021 and contains recommendations to address historic injustices that led to unequal burden of disease and death during COVID-19 for vulnerable populations.

Racial Justice and Health Equity Framework, Boston Public Health Commission. BPHC’s Health Equity Framework for understanding health inequities shows how racism and other systems of oppression (homophobia, ableism, transphobia, sexism, and xenophobia) have an independent influence on all the social determinants of health and can have a direct impact on health outcomes. 

Massachusetts Attorney General's Office: "Building Toward Racial Justice and Equity in Health: A Call to Action." This report from the Attorney General’s Office highlights longstanding disparities and the disproportionate toll that the COVID-19 pandemic has taken on communities of color in Massachusetts.

Massachusetts COVID-19 Health Equity Advisory Group. The primary function of the advisory group was to generate a series of recommendations for the Commissioner of the Massachusetts Department of Public Health on how the COVID-19 pandemic response could be informed by a health equity lens to ensure equitable access to resources and services, and prevent inequities and disproportionate negative outcomes.

Massachusetts Department of Public Health (DPH) COVID-19 Community Impact Survey. The COVID-19 Community Impact Survey (CCIS) was conducted in Fall 2020 to better understand the immediate and long-term health needs, including social and economic consequences, facing the Commonwealth due to the COVID-19 pandemic. The online anonymous survey was offered to both youth and adults across the Commonwealth by computer, phone, or tablet, and was available in English, Spanish, Portuguese, Simplified Chinese, Traditional Chinese, Haitian Creole, Vietnamese, Khmer, Cape Verdean Creole, Russian, and Arabic.

Rhode Island’s Health Equity Zone (HEZ) Initiative. Rhode Island’s Health Equity Zone initiative is a health equity-centered approach to prevention work that leverages place-based, community-led solutions to address the social determinants of health (SDoH).