On November 15, 2023, the Centers for Medicare & Medicaid Services released its proposed 2025 Notice of Benefit and Payment Parameters, the annual regulation which governs core provisions of the Affordable Care Act. This expert perspective focuses on aspects of the proposed rule likely to be of interest to state officials, including requirements for State-Based Marketplaces to align with the standards of the Federally Facilitated Marketplace, proposals for states to update essential health benefits, and initiatives to ease the eligibility and enrollment process for consumers.
Health Equity Measurement: Considerations for Selecting a Benchmark
Emily Zylla, Andrea Stewart, and Elizabeth Lukanen, SHADAC
As states look to advance health equity, they need ways to measure whether their efforts result in improvements. Benchmarking can be used to identify health disparities and establish a standard for evaluating efforts to address health inequities. There is no single ideal benchmark for health equity measurement and it is important to weigh the advantages and disadvantages of each before selecting an approach. This brief summarizes the advantages and disadvantages of four common approaches to health equity benchmarking: 1) Using the best-performing group as a reference; 2) using the most socially advantaged group as a reference; 3) comparing against a population average; and 4) comparing against a set target or goal. The rationale for selecting a benchmarking approach should be thoroughly explained and accompanied by detailed context and interpretation, acknowledging the role of societal inequality and structural racism in driving disparities to prevent the perception that individual subgroups carry responsibility for the observed disparities.