How Elevance Health is working with NCQA and Harvard to advance its health equity work

Health equity has become a common buzzword in the industry that often shows up in company mission statements and policies.

As organizations try to move from policies to real-world action in addressing health disparities, some providers and payers are working with outside organizations like the National Committee for Quality Assurance (NCQA) to try to make measurable progress.

Elevance Health, formerly Anthem, announced that 21 of its affiliated Medicaid plans earned full three-year accreditation for health equity from NCQA. The health equity accreditation provides an actionable framework to guide and evaluate organizations' health equity work, according to the nonprofit organization.

The accreditation was earned by Elevance Health affiliates in 20 U.S. states.

“Ninety-three percent of our Medicaid members are now served by a health plan that has earned this health equity accreditation, a scale unmatched in the industry. It’s an opportunity to continue to address the unique needs and improve the health of the diverse communities we serve," said Aimée Dailey, president of Medicaid at Elevance Health, in a statement.

Those 21 Medicaid plans serve 8 million members, according to the company.

"A lot of times when people think about accreditation, I think there's a misconception that it's just about checking a box. For Elevance Health, it's not. It really builds upon some of the foundations that we have laid as an organization from which we can further innovate," Darrell Gray II, M.D., Elevance Health's chief health equity officer, said in an interview.

Gray, a gastroenterologist, joined Elevance a year ago as its first executive to lead an organizationwide health equity strategy for the company's 45 million members. Prior to Elevance, Gray served as an associate professor of medicine at The Ohio State University and medical director of healthy communities for The Ohio State University Wexner Medical Center.

"For me, it was an attractive opportunity to work for an organization that has historically already been doing work in reducing health disparities but really had a clear vision on putting health equity at the core of all that we do to advance health equity and whole health for everyone," Gray said.

According to Gray, Elevance Health has a “health equity by design” philosophy that focuses on whole health that encompasses physical, behavioral and social health.

"Advancing health equity is a necessity for us. It's not just a moral and social imperative. It is also a business imperative," he said. "Our health equity by design approach is aligned, not as a separate vertical business, but integrated into all that we do across all of our key strategic pillars from exceptional experiences to digital platforms to care enablement to whole health. It cuts across all those strategic priorities for us as an organization and its business aligned."

A key pillar of this strategy is collecting, analyzing and reporting member data, including preferences, demographics and attributes to provide individualized care. Elevance Health also focuses on providing physicians with resources, tools and training to improve health equity.

Earlier this month, the company enrolled an initial cohort of 20 Medicaid leaders in the Harvard T.H. Chan School of Public Health’s “Leadership Development to Advance Equity in Health" course.

"We also think about health equity as it pertains to innovation in benefit design. We think about it also in ways that people may not readily think of such as what we're doing in the pharmacy space to advance pharmaco equity, which is when everyone has access to affordable evidence-based medical therapies," Gray said.

Earlier this year, Elevance subsidiary Simply Healthcare Plans was one of nine organizations that participated in a NCQA pilot program that helps healthcare organizations establish processes and cross-sector partnerships that identify and address social risk factors in their communities. Other organizations that participated include Geisinger Health Plan, UPMC Health Plan and health systems Hennepin Healthcare and Novant Health.

NCQA plans to change its quality measures for the 2023 Healthcare Effectiveness Data and Information Set, including race and ethnicity data and gender-relevant care measures. The changes aim to incentivize health plans to take more decisive steps toward health equity, the organization said.

Earlier this year, NCQA awarded Centene for its efforts in promoting health equity by improving care disparities in chronic disease prevention.

Elevance Health's recent NCQA health equity accreditation for 21 Medicaid plans marks "just the beginning" of the payer's work, Gray said.

"Partnering with NCQA provides reinforcement that we're on the right path and that we are doing some cutting-edge work to better serve our members and the broader community," he said. "We already have our eyes set on what we can do to achieve those broader goals across more of our plans, and even extending beyond what we've already done in Medicaid to our diverse portfolio as we think about our commercial and Medicare and exchange plans as well."