Advancing Health Equity: A Recommended Health Equity Framework for Accountability in Medicaid

National Committee for Quality Assurance


Advancing health equity through health plans is a national priority. Medicaid programs are at the forefront of this effort because they serve populations that have low incomes and/or are likely to have limited access to health care services. More than two-thirds of Medicaid enrollees receive care through comprehensive, risk-based managed care organizations. Quality measures are key elements of accountability in managed care programs. This creates an opportunity to align quality and performance strategies with equity-centered approaches to address disparities and close gaps in health care and health outcomes.

With support from CHCF, the National Committee for Quality Assurance (NCQA) developed a health equity measurement framework that state Medicaid programs can use to measure accountability in health plan managed care contracting. Advancing Health Equity: A Recommended Health Equity Framework for Accountability in Medicaid provides a list of six core quality domains, each with two to five associated quality measures.

Equity Framework

The authors examined peer-reviewed and grey literature, conceptual and measurement models, policy statements, and state contracting documents, and engaged key stakeholders to develop the framework. It prioritizes racial equity but is designed to expand beyond race and ethnicity.

The framework builds on NCQA’s white paper, Evaluating Medicaid’s Use of Quality Measurement to Achieve Equity Goals (available at the same link), which describes the current state of health equity quality measure use and application among state Medicaid programs.

The @NCQA @CHCFNews Medicaid #healthequity framework is a new tool to measure accountability in health plan managed care contracting. https://www.ncqa.org/health-equity/measure-accountability/ Click To Tweet

About the Authors 
The report was authored by the following NCQA staff: Rachel Harrington, Alana Burke, and Amaya Hampton.