Health Equity Plan Update -

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Health Equity Plan UpdateClosing the gap to address disparities and improvehealth care outcomes for Health First Colorado andChild Health Plan Plus (CHP ) membersEffective July 1, 2022Aaron Green, MSM, MSWHealth Disparities and Equity, Diversity & Inclusion OfficerExecutive Director’s Office (EDO) & Office of Cost Control and Quality Improvement (CCQI)1

Our Mission:Improving health care equity, access and outcomes for thepeople we serve while saving Coloradans money on health careand driving value for Colorado.2

Land AcknowledgementWe would like to acknowledge that what is now Colorado includes the lands of the Ute,Arapaho, Cheyenne, Diné (di-NAY), Lakota, Apache, Puebloan nations, and many Tribes, andthat the sovereign tribal governments of the Ute Mountain Ute and the Southern Ute IndianTribes still reside in this state. These tribes are the original stewards of these natural areas.We want to take a moment to honor and respect these original stewards of the environmentand their relationship with the land.3

Department Short andLong Term Projects /Initiatives4

Mission statement &strategic pillarsHow we organize ourworkMotivation behindour workEmployeeSatisfactionMemberHealth Empower staff andimprove equity,diversity, inclusion& accessibility. Improve memberhealth outcomesand reducedisparities in care.AffordabilityLeadership Reduce the cost ofhealth care inColorado to savepeople money onhealth care.Improve healthcare equity, accessCare Access& outcomes for the Improve memberpeople we serve while access toaffordable, highsaving Coloradansmoney on health care quality care.& driving value forColoradoHealth FirstColorado Value Ensure the rightservices, at theright place, andthe right price.OperationalExcellence &Customer Service Provide excellent service tomembers, providers &partners, compliant,efficient, effectiveperson- & familycenteredpractices.5

Within the pillars, priority projects help us achieveabout 45 Dept FY2022/23 GoalsMember HealthCare AccessOperationalExcellence &Customer ServiceHealth FirstColorado plement healthequity planExpand & supporthealth careworkforceEnable coveragecontinuityExpand valuebased payments &insightsReducecommercialpharmacy costsQuickly andcarefully fill openpositionsTransformbehavioral healthIncrease #/%providers seeingmembersMake eligibility &enrollment easyImplementeConsults &telehealth strategyPromotetransparenthospital pricesAccelerate equity,diversity,inclusion,accessibilityImplement community-basedcareImprove MedicaidenterprisesolutionsDevelopAccountable CareCollaborative 3.0strategyAdvancecommunity & ruralinvestmentAddress managerworkloadAdvance hospitaltransformationprogramRedesign casemanagementEnsure servicequality networkwideProduce cost &quality indicatorsPropel & alignvalue basedpaymentsFoster careergrowth &flexibility*HCPF has 45 goals this year that are summarized and grouped in the above key areas6

Health Equity is a top department priorityMemberHealthImplement healthequity plan7

New! Dept. Health Equity Plan Applied health equity lens across all programs andinitiativesStratifying data analytics to identify disparitiesHealth Equity Plans in RAE/MCE contractseffective. 7.1.22Aligned with Governors Executive Order 175, SB21181, CDPHE/OHE to address health disparitiesInternal EDIA work (over 25 events) for staffFocused efforts around vaccinations (COVID-19),maternity and perinatal health, behavioral health andprevention Ongoing effort to close COVID-19 vaccination disparity gapMaternity research and reportingBehavioral health investments and transformationIncrease access to prevention and expansion of quality care8

Health Equity Phase ISFY 2022-2025 (and beyond)202220222022202223-242025Implement HealthEquity PlanVendor ContractsStatewide TaskForceDashboard &Spec DocumentExplore Disparities &Policy OpportunitiesACC 3.0Effective June 30, 2022Effective July 1, 2022Beginning July September 2022October - DecemberHCPF formallylaunched strategic plan(SB 21-181) to addresshealth disparities.RAEs/MCE’s required tosubmit health equityplans by July 31, 2023Monitor performancemeasures and identifyadditional gaps anddevelop targetedinterventionsConvening of 20 stakeholders focusing onaddressing healthdisparities and provideactionablerecommendations toHCPFCreation of healthequity plan dashboardto track and monitorperformance measures;Specification documentto establishexpectationsHealth equity will beembedded in ACC 3.0through membercentricityIdentify 1-3 health equitypolicies (via statewideSenate Bill 21-181)9

Vaccination Rates (COVID-19)Maternity and Perinatal HealthBehavioral HealthPrevention and PopulationHealthShort term projects: Activities or projects to accomplish in the near future (i.e. 12 months or less) Collaborate with Health FirstColorado Primary CareProviders to eliminatebarriers to COVID-19vaccination ratesMonitor RAE compliance againstsubmitted strategies to addressCOVID-19 vaccination rates.Identify barriers and createplans to further addressbarriers with a focus on targetpopulationsCollaborate with congregantsetting providers to ensure aHealth First Colorado membervaccination rate above 85% andthat each provider is compliantwith the CDPHE vaccinationdistribution requirements, asdefined in rule.Continue to collaborate withCDPHE on outreach activities. Evolve the Department’s HealthFirst Colorado MaternityAlternative Payment Model(APM).Document the experience ofBlack, Indigenous, People ofColor (BIPOC) birthing peopleto increase maternity healthdisparity drivers and insights365 Days of PostpartumCoverage. Implement SB21194, which provides theDepartment with authority toensure all members receive afull year (instead of 60 days)of postpartum coverage.Expanded PopulationCoverage for Family PlanningServices. Implement SB21-009and SB21-025 which supportfamily planning and coveragefor undocumented Coloradansto reduce the incidence ofunintended pregnancy, whichreduces adverse perinatal andneonatal outcomes. Increased the Health FirstColorado behavioral healthnetwork to more than 11,000active behavioral healthproviders.Create a report that identifiesthose providers who areenrolled but not seeingpatients, and create outreachto identify why.Behavioral health communitygrants and training. ProvideBehavioral Health communitygrants to expand behavioralhealth capacity specific tocommunity members' needs withculturally relevant serviceaccess, availability, anddelivery.Alternative Payment Model(APM). Ensure the equityframework is utilized indeveloping a new alternativepayment model (APM) and valuemeasures during this interval andevaluate the effectiveness of theframework in current behavioralhealth efforts.Improve Diabetes A1C control inpopulations at risk by: Analyze data in collaborationwith RAE/MCO partners toidentify disparities(race/ethnicity, age, gender,language, disability) andidentify priority populations Inventory the percent ofmembers with diabetesenrolled in RAE diabetesprograms Continue to improve dataquality by increasing access toprovider lab data and improvingprovider documentation ofservices provided and level ofdisease control Collaborate with FQHCs todevelop Diabetes selfmanagement education (DSME)program opportunities toimprove patient health equitythrough evidence basedmedicineCreate the initiatives to increase wellchild visits.Dept. Short Term Projects/Initiatives10

Vaccination Rates (COVID-19)Maternity and Perinatal HealthBehavioral HealthPrevention and PopulationHealthLong term projects: More than 12 months, requiring additional time and planning Determine additional strategiesneeded to close the COVID-19vaccination disparity equal tothe overall Colorado populationand Health First Colorado/CHP vaccination disparity. Maternity Health Equity Plan.Develop and implement aMaternity Equity Plan thataddresses maternal morbidity inBlack, Indigenous, People ofColor (BIPOC) communities.Leverage the HospitalQuality Incentive Payment(HQIP) Program - Hospitalincentive program focusedon maternal health, patientsafety and patientexperience measures.Includes measures onMaternal Depression andAnxiety, MaternalEmergencies, Zero Suicide,and Racial and EthnicDisparities.Leverage HTP. Improvehospital care by tying CHASEfee-funded hospitalpayments to quality-basedinitiatives through theHospital TransformationProgram (HTP Work with sister departmentsto expand broadband andtelehealth in rural communitiesto improve tele-behavioralhealth care access and reducereluctance to seek care due tostigma. Identify Social Risk Factors(SRF) through the lens of socialdeterminants of health anddevelop predictive analyticstools to gather appropriate datafor social needs to promotehealth equity Expand behavioral healthmobile crisis benefit anddevelop securetransportation benefit toreduce reliance on lawenforcement and ensureequitable access to services,which will require providers tobecome proficient inprocedures for crisis responseand transport for individualswith disabilities, individualswho are deaf/hard of hearing,and individuals who are nonEnglish speaking or nonEnglish proficient. Work with OeHI and statepartners to release and reviewthe Request for Proposals (RFP)that will procure a partner toimplement the 2nd Phase ofthe Prescriber Tool, whichallows providers and casemanagement to better addresssocial determinants of health forHealth First Colorado members. Work with providers andadvocates to collect data tobetter screen for whole-personservice needs and identifydisparities related to upstreamand downstream determinants.Dept. Long Term Projects/Initiatives11

Coming Soon!Health Equity PlanDashboard Specification Document Tracking/MonitoringData requirementsEvaluation and baseline periodBaseline populationDepartment will pull the dataClaims selection criteriaIdentify baseline % and performance measures Spec document will provide guidance and criteria10 indicators x 7 RAEs (70 measures)Disparity data for RAE’s to choose fromWorking with Quality Performance on timelineTentative October/November timeline12

Qualifying Incentive Performance MeasuresIndicatorDescriptionOwnerIndicator 2Core Measure NQF 0059: Comprehensive Diabetes Care, Hemoglobin A1cPoor Control 9%1) Core Measure NQF 1392: Well-child Visits in the first 30 months of life(2) Core Measure NQF 1516: Child and Adolescent Well-care Visits (ages 321)Indicator 3Core Measure NQF 0038: Childhood Immunization StatusCMSIndicator 4Core Measure NQF 1407: Immunizations for AdolescentsCMSIndicator 5Indicator 610% increase in booster vaccination rateIndicator 1CMSCMSCore Measure NQF 3489: Follow-up after Emergency Department Visit forMental IllnessCore Measure NQF 3488: Follow-up after Emergency Department Visit forAlcohol and Other Drug Abuse or DependenceCMSIndicator 8Core Measure NQF 0576: Follow-up after Hospitalization for Mental IllnessCMSIndicator 9HEDIS measure DSF: Depression Screening and Follow-upIndicator 10Core Measure NQF 1517: Timeliness of Prenatal Care (PPC-CH)Indicator 7CMSCMS13

FAQ’s Additional Clarification How will the department evaluate progress on the four focus areas? Specifically related to how are the focus areas being calculated? Baseline measures Timeline for collection of data and meeting goals Currently working with Quality Performance Unit Supervisor to identify DataTimeframes The Department will pull the data, and share with RAEs/MCOs Starting August 1, 2023, each metric will be tracked and pulled dependent on thetimeframe set RAEs/MCOs have the option to provide quarterly or annual reports based on availabledata and reporting structure - TBD Lookback period - starting October 1, 2023 Based on data availability Deliverables/requirement clarification DAS will be working on a Health Equity Plan Dashboard to track and measure health equityplan measures (expected November 2022) Plan template can be found here Accepting Instructions and Narrative Template plan feedback by 9/30/23Instructions and Narrative template can be found here. Due 7/31/202314

Care Analyzer Data AvailabilityPerformance PeriodHCPF AvailabilityColorado Data Analytics Portal (CDAP) & Quality Dashboard(Dates are approximate)RAE Reporting on Health EquityDashboardJan 1 – Dec 31April 30May 15TBDApr 1 – Mar 31July 31Aug 15TBDJul 1 Jun 30Oct 31Nov 15TBDOct 1 – Sept 30Jan 31Feb 15TBD15

Action Plans and Contract Requirements HCPF will pull data 7 regions x 10 measures (70 total) andRAEs/MCO’s can identify priority populationsand to begin to identify appropriatestrategies and targeted interventions toreduce disparities. Each action plan will follow the belowcriteria: Identify health disparities and priority populations(HCPF will pull the data) Define goals Determine needs/resources Monitor and evaluateprogressInstructions and Narrative template can be found here. Due 9/30/202316

Draft Narrative and Instructions - COVID-19Strategies to Address Health Disparities inLong-Term Health Equity PlansInclude strategy, timelines, resources,partnerships, incentive/pass through plans,logistics, goals, and any other relevantinformation to identify and address healthdisparities.1. Using the table below, please explainthe RAEs/MCEs overall approach andstrategy to:Overall approach of addressing COVID-19related disparity gaps among members.Reference Long-Term COVID-19Monitoring Plan.a.Identify, monitor, measure andincrease vaccination rates amongolder adults.b.Overall strategyFocus AreaCOVID-19VaccinationRatesCOVID-19 Vaccination Rates Action Plan &StrategyIdentify Disparity #1 - Vaccination rates amongolder adults and other member populations) Population 1 - Older Adults Population 2 - TBD after data disaggregation Metric: 10% increase in booster vaccinationrateIdentify Disparity #2 - TBD by RAE/MCO Population 1 - TBD after data disaggregation Population 2 - TBD after data disaggregation Metric: TBD17

Draft Narrative and Instructions - MaternityFocus AreaStrategies to Address Health Disparities inLong-Term Health Equity PlansInclude strategy, timelines, resources,partnerships, incentive/pass through plans,logistics, goals, and any other relevantinformation to identify and address healthdisparities.1. Using the table below, please explainthe RAEs/MCEs overall approach andstrategy to:Overall approach of addressingMaternity and Perinatal Health relateddisparity gaps among members.Maternity and Perinatal Health Action Plan & StrategyMaternity andIdentify Disparity #1 - Prenatal Access to CarePerinatal Health Population 1 - TBD after datadisaggregation Population 2 - TBD after datadisaggregation CMS Core Measure: Core Measure NQF1517: Timeliness of Prenatal Care (PPCCH)Identify Disparity #2 - Postpartum access to carea. Identify, monitor, measuretimeliness of prenatal andpostpartum access to care. Population 1 - TBD after datadisaggregationb. Overall strategy Population 2 - TBD after datadisaggregation Metric : Core Measure NQF 1517:Postpartum Care (PPC-AD)18

Draft Narrative and Instructions - Behavioral HealthStrategies to Address Health Disparities inLong-Term Health Equity PlansInclude strategy, timelines, resources,partnerships, incentive/pass through plans,logistics, goals, and any other relevantinformation to identify and address healthdisparities.1. Using the table below, please explainthe RAEs/MCEs overall approach andstrategy to:Overall approach of addressingBehavioral Health related disparity gapsamong members.a. Identify, monitor, measure followup after ED visit for mental illness,alcohol and other drug abuse ordependence, hospitalizations formental illness, and depressionscreening follow-up.b. Overall strategyFocus AreaBehavioralHealthBehavioral Health Action Plan & StrategyIdentify Disparity #1 - Appointment follow up post-ED for mental health Population 1 - TBD after data disaggregation Population 2 - TBD after data disaggregation CMS Core Measure: Core Measure NQF 3489: Follow-up after EmergencyDepartment Visit for Mental IllnessIdentify Disparity #2 - Appointment follow up post-ED for SUD Population 1 - TBD after data disaggregation Population 2 - TBD after data disaggregation Metric : Core Measure NQF 3488: Follow-up after Emergency Department Visitfor Alcohol and Other Drug Abuse or DependenceIdentify Disparity #3 - Hospitalizations for mental health emergencies Population 1 - TBD after data disaggregation Population 2 - TBD after data disaggregation Metric: Core Measure NQF 0576: Follow-up after Hospitalization for MentalIllnessIdentify Disparity #4 - Depression screenings and follow-up Population 1 - TBD after data disaggregation Population 2 - TBD after data disaggregation Metric: HEDIS measure DSF: Depression Screening and Follow-up19

Draft Narrative and Instructions - PreventionFocus AreaStrategies to Address Health Disparities inLong-Term Health Equity PlansInclude strategy, timelines, resources,partnerships, incentive/pass through plans,logistics, goals, and any other relevantinformation to identify and address healthdisparities.1. Using the table below, please explainthe RAEs/MCEs overall approach andstrategy to:Overall approach of addressingPrevention / Population Health relateddisparity gaps among members.a. Identify, monitor, measurechildhood immunization status,immunizations for adolescents,diabetes and well-child visitsb. Overall strategyPrevention /PopulationHealthPrevention / Population Health Action Plan &StrategyIdentify Disparity #1 - Childhood immunization status Population 1 - TBD after data disaggregation Population 2 - TBD after data disaggregation Metric: Core Measure NQF 0038: Childhood Immunization StatusIdentify Disparity #2 - Immunization for adolescents Population 1 - TBD after data disaggregation Population 2 - TBD after data disaggregation Metric : Core Measure NQF 1407: Immunizations for AdolescentsIdentify Disparity #3 - Decrease diabetes poor A1C control in populations at risk Population 1 - TBD after data disaggregation Population 2 - TBD after data disaggregation Metric: Core Measure NQF 0059 Comprehensive Diabetes Care: Hemoglobin A1c(HbA1c) Poor Control ( 9.0%) (HPC-AD)Identify Disparity #4 - Increase well child visits while reducing disparities in visits amongpriority populations Population 1 - TBD after data disaggregation Population 2 - TBD after data disaggregation Metric: Percentage of children/youth receiving preventive visits through EPSDT;Core Measure NQF 1392 Well-Child Visits in the First 30 Months of Life (W30-CH);NQF 1516 Child and Adolescent Well-Care Visits (WCV-CH)20

Recommended Changes toMedicaid Application Long Term Project21

Priority recommendations - optional questionsThe following changes to include self-identifying options for: Sexual Orientation: recommend adding this question Gender (required birth sex question): recommend theaddition of options for transgender members Race/Ethnicity: recommend a single question andadditional options Language: recommend additional questions around Englishknowledge Housing status: recommendations for application cleanup

Joint Health Disparities WorkgroupHealth EquityTask Force Statewide effort to identify andeliminate health disparities Develop strategies andrecommendations for future-workand priority setting HCPF, SME’s, RAEs/MCOs,MembersImprove health equity outcomes with cross-sector partners Intentional focus on underserved and marginalized groups andpopulations in CO Develop systems for real time data collection and informationsharing among partners Joint efforts to reduce poor health outcomes for all members

Health Equity Task ForcePlanning SessionsJuly 13, 2022 11 a.m.-1 p.m.Virtual Zoom LinkAug.31, 2022 11 a.m.-1 p.m.Virtual Zoom LinkSept. 28, 2022 11 a.m.-1 p.m.Virtual Zoom Link


Thank you!26

Contact InfoAaron Green, MSM, MSWHealth Disparities and Equity, Diversity & Inclusion

Additional Slides28

7/19/22 Annual Stakeholder recapAnnual Stakeholder Webinar on 7/19 was very successful – great feedback. Withabout 700 stakeholders voting: Most opportunistic focus areas they wanted HCPF focused on included:behavioral health, which got 33% of the votes. 15% voted for HCBS transformation,and 10% voted for advancing health equity and Value Based Payments. The audience’s top concerns were: 38% voted on growing the healthcareworkforce. 33% listed the balance between inflation, provider rates, workforceaccess, and Medicaid affordability. Last, 22% were most concerned about continuousmember coverage following the end of the PHE. Of our 6 pillars, the stakeholders said the most important were: 35% voted forcare access (which parallels the health care workforce concern), 29% saidAffordability for ALL Coloradans29

Background In alignment with SB 21-181, HCPF partnered with theGovernor's Office, CDPHE, and OHE The Department of Health Care Policy & Financing (theDepartment) provides health coverage to Coloradanswho qualify through programs such as Health FirstColorado (Colorado's Medicaid program) and ChildHealth Plan Plus (CHP ). A comprehensive list of allour programs is on our website. Health First Colorado covers members in everycounty of our state. From rural Colorado, where inmany counties the enrollment is higher than the stateaverage, to the front range. Health First Coloradocovers Coloradans of all ages and abilities, as well asmore than 40% of births in the state each year. First-of-its-Kind Health Equity Plan is now live!30

By The Numbers Our programs serve Coloradans with disabilities andlow-income of all ages whose socioeconomic status isintrinsically linked to their state of health. 1 in 4 Coloradans (1.6 Million) Our members report 56 or more distinct primary orspoken languages 10.8% of members self-identify as Spanish speakers 88.0% self-identify as English speakers 1.2% self-identify as speakers of another language(As of June 14, 2022). Language access is critical, and the utilization ofinterpretation services is a priority for our Department31

What are health and health care disparities? Health and health care disparities refer to differences in health and health care between groups thatstem from broader inequities. There are multiple definitions of health disparities. Healthy People 2020 defines a health disparity as, “aparticular type of health difference that is closely linked with social, economic, and/or environmentaldisadvantage” and notes that disparities, “adversely affect groups of people who have systematicallyexperienced greater obstacles to health based on their racial or ethnic group; religion; socioeconomicstatus; gender; age; mental health; cognitive, sensory, or physical disability; sexual orientation or genderidentity; geographic location; or other characteristics historically linked to discrimination or exclusion.” The Centers for Disease Control and Prevention (CDC) identifies health disparities as, “preventabledifferences in the burden of disease, injury, violence, or opportunities to achieve optimal health that areexperienced by socially disadvantaged populations.” A health care disparity typically refers to differences between groups in health insurance coverage, accessto and use of care, and quality of care. The terms “health inequality” and “inequity” also are used to referto disparities. Racism, which CDC defines as the structures, policies, practices, and norms that assign value and determineopportunities based on the way people look or the color of their skin, results in conditions that unfairlyadvantage some and disadvantage others, placing people of color at greater risk for poor health outcomes.Source: Kaiser Family Foundation32

Disparities exist in 6 areas:According to the 2021 National Health Care Quality and Disparities Report,disparities exist in these six areas:1. Patient safety2. Person-centered care3. Care coordination4. Effective treatment5. Healthy living6. Health care affordabilityIt is critical to identify the current state of health disparities in these six areasin each Colorado region to appropriately allocate resources to regions withdisproportionately poor clinical outcomes for our members.Providers, caregivers, and stakeholders have voiced the need to have equitybased, quality outcomes data for their region so they may begin to addressColorado's health disparities.33

Key Populations and DemographicsRacial/Ethnic GroupsAmerican Indian/AlaskaNativeAsian/Asian Americans,Native Hawaiians andPacific IslandersBlack/African AmericanHispanic/LatinoWhiteOther People of ColorAgeInfants/Children (0-12)Youth (12-18)Adults 65 and olderOther MarginalizedGroupsImmigrants and refugeesLGBTQIA peoplePeople with low incomePeople experiencinghomelessnessVeteransPregnant peopleFoster Care/Child WelfareMedically UnderservedPeople with disabilitiesPeople who require longterm services lUrbanFrontierRemoteOverall communityenvironmentsCongregate SettingsJailsPrisonsNursing Facilities34

Quality Data ManagementQuality dashboardsfocused on disparitymetrics and performancemeasures Develop robust dashboards thatstratify data Provide current or most updateddisparity data Embed health equity lens in metricdeliverables & analyticsStratify data by race/ethnicity, gender, language, geography,disability and other available identifiers Quality dataCenters for Medicare and Medicaid Services (CMS) Core MeasuresDepartment goals and measurementsChanges to Medicaid application; Access to data35

Health Equity Community EngagementExternal lever:Stakeholder Engagement(Members, Providers,Partners) Engaged stakeholders in meaningfuldialogue, feedback, grassroots strategy Town halls, listening sessions Completed 12 public meetings Jan-June Health Equity and intentional conversations, input from stakeholdersacross all of Colorado Members with lived experience (Member Experience Advisory Council) Regional Accountable Entities (RAEs), Managed Care Entities (MCE’s) Ongoing Community stakeholders from all intersectional identities African American, American Indian/Alaska Native, LGBTQIA , Disability,Non-English speakers, Immigrants, Refugees and more!36

Vendor Plan Feedback due by 9/30/31 Health Equity Plan addedto vendor contracts The Department will pull the data and allowRAEs/MCO’s to identify target disparitiesExploration: Identify regional disparities,incentive measures to close gapsVendor plans due 7/31/23Embed Health Equity Plans into health delivery systemvendor contracts, in order to accomplish the following: Mutual responsibility and accountability to reduce healthdisparities for all members Establish regionalized metrics and specific population areas totarget, outreach, and improve health outcomesInstructions and Narrative Language can be found here.

Accessibility for All - HB21-1110 State of Colorado AccessibilityStatement: The State of Colorado is committed to providingequitable access to our services to all Coloradans. Our ongoing accessibility effort works towards beingin line with the Web Content Accessibility Guidelines(WCAG) version 2.1, levels A and AA criteria. Theseguidelines not only help make web content accessibleto users with sensory, cognitive, and mobilitydisabilities but ultimately to all users, regardless ofability.Internal HB21-1110 ProjectImplementation WorkgroupLanguage Access - Both translation ANDinterpretation services are criticallyimportant for ensuring that theinformation and materials HCPF sharesare inclusive and accessible by anyonewho needs them.Guide to Accessible Web Services (OIT)Accessibility Glossary A-Z38

“AORTA”FrameworkHealth EquityACTION Quality Data driven Performance measures Forward focused Targeted impact Affordability and costsavingsAWARENESS Historical context andcurrent systemic racism anddiscrimination Systemic analysis Education and training Upstream: SocialDeterminants of HealthAWARENESSACTIONOPPORTUNITIESOPPORTUNITIES Knowledge Best Practices & Models Partnerships Innovation Policy and practicechanges to addressdisparitiesRECONCILIATION Storytelling Racial healing Assets framing ofresistance and triumph Member experiencedrivenTRUSTTRUST BUILDINGRECONCILIATIONBUILDING Fostering truth Alliance Building39 Humility, vulnerability Naming past andpresent harms/trauma TimeThe AORTA health equity framework is centered on the key components of visualizing, normalizing, organizing and operationalizingracial equity approach (from the Government Alliance on Race & Equity) A Cycle of Practice and LearningTo learn more about the AORTA Framework, click here.

HEALTH EQUITY LENSThe Five I’s of Equity, Diversity, Inclusion & Accessibility ionAORTA Framework Pillars and PrinciplesAWARENESSOPPORTUNITY Organizationalreadines s Education Training Ups tream SDOH Addres sdis parities Knowledge Bes t practices Areas ofimprovement Partners hips Growth minds etRECONCILIATIONTRUST BUILDING Storytelling Racial healing Memberexperience(tribal, urban,frontier, rural) RelationalFos tering truthAlliance buildingSus tainedSafety netShared powerACTION Quality datadriven Performancemetrics Targetedinves tments Affordability andcos t s ENGAGEMENTINTEGRITYCONTINUOUSIMPROVEMENTTHE AORTA HEALTH EQUITY FRAMEWORK IS THE FOUNDATION OF OUR PRACTICE

Health Equity LensRun each decision through an Equity, Diversity, and Inclusion Lenswith the followingquestions: How are people from different underserved groups affected by this issue? What does the data tell us? What is missing from the data? If this policy is adopted, who is burdened most and who benefits most? If this policy is ado

Colorado (Colorado's Medicaid program) and Child Health Plan Plus (CHP ). A comprehensive list of all our programs is on our website. Health First Colorado covers members in every county of our state. From rural Colorado, where in many counties the enrollment is higher than the state average, to the front range. Health First Colorado

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