1. Advancing Equity and Reducing Disparities: Opportunities for Consumers Doriane C. Miller, MD Next Frontier of Consumer Engagement Aligning Forces For Quality Annual Meeting Washington DC November 12, 2014

2. Introductions/Why are you here?

3. Areas for Review Definition of health disparities Determinants of health Role of Affordable Care Act Advocacy Organizations Role of data and reporting: macro and micro Community-Health Systems partnerships Community Benefit Community Redevelopment

4. “Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” Preamble to the Constitution of the World Health Organization as adopted by the International Health Conference, New York, 19-22 June, 1946

5. Health Disparity: Definition Differences in health status seen in different populations tied to social, economic and environmental factors

6. Why do health disparities matter?

7. Determinants of Health

8. Affordable Care Act Exchange Plans: Best Practices ( Community Catalyst ) Ongoing diverse consumer input Effective language access to services Robust outreach targeting communities of color Simplify enrollment and protect privacy Ensure robust network of safety net providers Develop quality strategies to reduce disparities

9. How to get involved ACA recommends that State Health Exchanges solicit feedback on function: consumers, insurers, advocacy groups and health providers Find out in your state what programs are in place to provide feedback

12. Partnership with National Advocacy Organizations Issue specific Technical assistance Multiplier effect Civic engagement: fraternities, sororities, service organizations

15. Data: Measurement for Change ACA requires the collection of data on race, ethnicity (REL) and language for all programs receiving Federal health care funding reported to HHS Uniform Data Sets (UDS) for Health Resources and Services Administration funded programs: Federally Qualified Health Centers, Migrant Health Centers, Homeless, Public Housing (330 programs) Measures include REL, preventive care, primary diagnoses for patients treated Data available thru HRSA website, not user friendly Consumer role: asking for data about area of health disparities at the local level/population health—linkage to the health delivery system

16. Community Benefit Programs and services designed to improve health in communities and increase access to health care Programs may take place in the community and must have a measurable impact Must take place in conjunction with a Community Health Needs Assessment—requires community input Must be made available to the public and reported to the IRS—link to non-profit status

18. Community-Health Systems Partnerships Impetus: Population Health Improvement Influencers: Social Determinants of Health (economics, education, environment, behavior) Programs/Touch Points: Faith-based, geographic community, schools, housing Role of Public Health: data, programs, funding, convening

19. National Quality Strategy Estimated that ¼ of health care costs are due to modifiable factors Priority for the inclusion of community efforts that impact health Development of a framework for health care delivery systems to work with community organizations, public health and the civic sector to improve health

20. Community Redevelopment: Place Matters Social ties Access to healthy foods Safety Recreation

21. Community Redevelopment Agencies: Local Initiative Support Corporations Helping community residents transform distressed neighborhoods into healthy and sustainable communities of choice and opportunity — good places to work, do business and raise children. LISC mobilizes corporate, government and philanthropic support to provide local community development organizations with – loans, grants and equity investments – local, statewide and national policy support – technical and management assistance

24. Small Groups Advocacy Work with health care delivery systems Funding/community benefit Community/public health partnerships Successes/current activities Ongoing challenges Suggestions for improvement