New Analysis Sums Up How to Measure Health Equity

This blog post was originally authored by Andy Reynolds of the National Committee for Quality Assurance (NQCA).

Health equity is essential to ensuring quality health care—there can be no quality without equity.

Most health equity measures focus on evaluating health disparities and stratifying measures using social determinants of health (e.g., race, ethnicity, income, level of education).

To better measure health equity in new ways that integrate performance measures, a new NCQA policy brief reviews four measurement approaches for states’ Medicaid managed care programs.

Measuring Health Equity: A Review of Scoring Approaches—funded by the California Health Care Foundation—is part of our larger work examining quality measurement for Medicaid programs.

An examination of peer-reviewed and gray literature uncovered four criteria for measuring equitable care:

1. Select indicators of social determinants of health.
2. Select a reference group (a “standard” comparison group independent of the data vs. the data informing the comparison group).
3. Select health care quality metrics. These could include composites (e.g., vaccination rates, quality measures, infant mortality rates).
4. Use benchmarks (e.g., compare results to national estimates).

The four approaches are similar in how they:

• Underscore key dimensions for measuring care and outcomes.
• Can lay a foundation for a diversified measurement landscape.
• These approaches give state Medicaid programs options for how to evaluate health plan quality performance – which can help focus quality improvement initiatives to advance health equity.