What Is Health Equity Accreditation? Everything You Need to Know

• Health Equity Accreditation programs outline steps a hospital can take to identify and address gaps in access to high-quality care.
• Nurses play a pivotal role in advocating for organizations to seek accreditation and helping implement many of the changes.

In 2021, the National Committee for Quality Assurance (NCQA) announced a program outlining a plan for hospitals to identify and permanently close care gaps in communities that often lack access to quality care.

According to the NCQA, racial disparities cost the U.S. an estimated $93 billion in medical costs and a little over $40 billion in lost productivity per year. Premature deaths also affect economic losses.

Since the NCQA’s initial announcement, entities, including The Joint Commission and, even more recently, the Utilization Review Accreditation Commission (URAC), have released such program versions. URAC, based in Washington, D.C., launched its health equity program this fall.

According to commission leaders, they already have organizations interested in the program and signing up.

However, every program is different, and requirements vary. Applying means substantial planning and legwork. Programs may require:

• Internal preparation and data collection before applying
• An appointed leader who will direct the program
• Completion of online training and education

The length of time from application to acceptance may also take time.

“[The process] is generally a four to six-month implementation,” said Shawn Griffin, MD, president and CEO of URAC, to NurseJournal. “One of the things I say is that we don’t sell accreditations; we actually sell the ability to apply for accreditation. There are organizations who try to achieve accreditation who don’t achieve it.”

Nurses also play a pivotal role in advocating for organizations to seek accreditation. They have personal investments in trying to challenge current healthcare standards and improve outcomes, especially in communities that face health disparities.

That is why one of URAC’s committee partners is The National Black Nurses Association. URAC’s health equity accreditation was designed with valuable input from their committee members, Griffin said.

Learn more about the requirements for health equity accreditation programs and the benefits of receiving accreditation.

What Is Health Equity Accreditation?

The NCQA defines health equity accreditation as “the foundation of health equity work [and of] building an internal culture that supports the organization’s external health equity work.”

The NCQA, The Joint Commission, and URAC are achieving this through their programs by:

• Identifying opportunities to reduce health inequities and improve care.
• Improving data collection and analysis of disparities in care to guide actions to address gaps.
• Collecting data that helps the organization create and offer language services.

The need for organizations to become health equity accredited came after overwhelming evidence of the lack of high-quality care offered to marginalized communities. Thus resulting in poor and, in many cases, preventable outcomes. Marginalized communities include populations grouped by:

• Gender
• Race
• Socioeconomic status
• Sexual orientation
• Cultural characteristics
• Age

A survey of healthcare executives conducted by Vantage Health Technologies reported that while close to 200 executives believe healthcare equity is extremely important, only 7-10% have a roadmap to address it.

Programs like health equity accreditation provide healthcare organizations with a measurable framework for improving healthcare in their communities.

URAC, the National Minority Quality Forum (NMQF), and many other organizations collaborated to create the Health Equity Accreditation program.

In a webinar hosted by The Joint Commission announcing their health equity accreditation program, Christina Cordero, Ph.D., MPH, executive director of hospital accreditation and certification programs for the environmental safety accreditation organization, explained what organizations should consider when applying.

“We want organizations to think about what the root causes are of those health care inequities to take a look at what the root causes are of any health care disparities that they’re identifying within their patient population and then to address those disparities with targeted interventions,” Cordero said in the webinar.

Healthcare industries and programs that address healthcare inequity have experienced political headwinds, specifically with diversity, equity, and inclusion (DEI) bans and the so-called “anti-woke” movement. States have signed into law to ban and defund DEI programs in colleges and universities.

According to an article in Modern Healthcare, these laws also affect healthcare industries. Hospitals must look into alternating languages in long-standing programs that address unconscious bias and cultural competency. They also have to adjust to new state laws regarding how to discuss and teach about race and racism in healthcare.

Although the URAC heard concerns from some of its partners and board, Griffin pointed out that URAC’s program is not so easy to define.

“Our program is not just about racial differences,” he told NurseJournal. “It’s also about economic differences, it’s about geographic differences, it’s about community differences. It’s about addressing inequalities wherever they come from and whatever is contributing to them.”

Health Equity Accreditation: What Are the Requirements?

The requirements for the Health Equity Accreditation vary by program. However, many program goals are to help organizations reach standards and guidelines that will benefit the communities they serve.

The NCQA’s health equity accreditation requirements include having organizations analyze their readiness to apply to the program first. It can take 9-12 months from applying to the program to receiving a decision. The pre-application portion includes:

1. Completing a consult call with a program expert.
2. Purchasing the standards and survey tools.
3. Conducting a gap analysis in the organization.
4. Submitting a pre-application form.
5. Submitting an online application.

Once the application is submitted, NCQA reviews it and works with the organization to align their research with program requirements.

URAC’s health equity accreditation is available to any healthcare organization.

“This is in contrast to some other health equity accreditation programs that are only available for certain types of organizations,” Dr. Giffin points out.

URAC tests that a healthcare organization has a formal health equity program that includes:

• A needs assessment
• A program description
• Metrics, evaluation, and strategic relationships with partners to achieve their goals
• A plan for improving program quality over time

The Joint Commission prides itself on following its long-standing standards, which have always addressed health equity. Their Health Equity Accreditation program requires the following:

• Designating a leader accountable for the healthcare equity initiatives
• Accessing healthcare-related social needs
• Analyzing quality and safety measures
• Creating an action plan
• Keeping stakeholders informed

The Joint Commission also requires organizations to extend the program to their employees. According to its webinar, the program will also collect self-reported data on staff members and leaders to identify improvements for healthcare equity within the organization.

The Joint Commission also offers a resource center that includes innovative strategies to help organizations throughout their application progress.

What Are the Benefits of Health Equity Accreditation?

Organizations obtaining a health equity accreditation are sealing their commitment to addressing health disparities within their communities and the patients they serve.

The NCQA distributes report cards to participants in the program. The report cards help recognize high-performing organizations dedicated to keeping their communities healthy and reducing healthcare costs. The NCQA report cards for accredited organizations can be accessed through its website.

“Improving population health is a foundational component of meeting the Triple Aim of healthcare, and URAC’s accreditation demonstrates excellence in doing so,” Dr. Griffin pointed out. “This accreditation demonstrates an organizational commitment to the principles of health equity and ensuring that an organization is meeting the needs of the diverse populations they serve.”

Meet Our Contributor

Dr. Shawn Griffin

Dr. Shawn Griffin is the president and CEO at URAC in Washington, D.C. He leads one of most trusted independent accrediting organizations in the country. At URAC, Dr. Griffin led the successful acquisition of a major competitor and launched the company into the global market. Dr. Griffin is a subject matter expert on population health, quality improvement, accreditation, telehealth, network development CINs, ACOs, and physician alignment.

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