CVS Health: 3 steps to achieving health equity accreditation

1.    Evaluate how health equity fits into your organization's mission

Gourdine, a career physician, said supporting clinical quality by focusing on health equity has always served as a north star in her practice. That principle stood strong in her work with CVS Caremark as the company decided to pursue URAC's health equity accreditation.

"Remember that there's no quality without health equity," Gourdine offered as a first step in this type of project. "If you think of equity in terms of quality of care, that's an important step in terms of ensuring that you thoroughly evaluate the work that's taking place in your organization."

This step is mission critical because it lays the foundation for the work that's to come and helps organizations elucidate their why. Although many healthcare organizations and companies have sought better health equity for decades, the public discourse around this work began in earnest within the past decade.

To that end, there's no clear, evidence-based roadmap toward more equitable care and services. Healthcare leaders are forging the path, and that's tough work to pursue without being grounded in organization-wide intention.

Gourdine said the URAC accreditation served as an opportunity to piece together the company's ongoing efforts toward health equity.

"We saw this as an opportunity to really validate the enterprise-wide commitment to health equity that we have at CVS Health," she said. "It's a core business priority. It is something that is embedded in each of our business units."

2.    Align health equity programs with accreditation standards

Of course, part of achieving any healthcare accreditation is laying out and understanding their standards.

According to Gourdine, URAC had a number of benchmarks CVS Health needed to hit to receive the health equity accreditation. These benchmarks, although stringent, ensure that organizations are held to a high standard in their work.

But that does not mean CVS Caremark or its partners across all of CVS Health had to start from scratch. Rather, Gourdine and her team assessed the URAC standards, evaluated CVS Health programming and looked at where there was alignment.

There is no need to reinvent the wheel, Gourdine indicated. Instead, organizations should look at where they are already hitting the accrediting body's standard. That mentality made this a significantly more manageable project, Gourdine added, because CVS Caremark was already progressing toward health equity and had key partners in the CVS Specialty Pharmacy line of business.

"There is no quality without health equity. Equity is really one of the key components of quality," Gourdine asserted.

"And so, in talking to the leadership and in working alongside URAC to understand what their requirements were, we began to sort of lay those out," she continued. "Our quality and accreditations team began to take a look at those requirements and align those requirements with those business units and those functions that exist in Caremark and in CVS Specialty in order to assume that there's alignment."

Gourdine said she and her team had to focus particularly on how they use the data they collect about patients. URAC's requirements about data collection and use are key, she said, because they get to the heart of how an entity like CVS Caremark might design health equity programming.

"So how do we leverage data? How do we identify individuals at risk for experiencing barriers to care? And then what do we do about it and how do we measure what we do?" Gourdine explained.

That attestation lays the groundwork for describing other programming, like supporting medication adherence for individuals facing care access barriers, for example.

"The other thing that was important for us to document was really within our own workforce," Gourdine added. "We strive to ensure that our workforce is really reflective of the communities that we serve. And this really gave us an opportunity to sit down and assess that and to be able to document that that was the case as well."

3.    Assemble your health equity accreditation team

Gourdine did not pursue this accreditation alone. She said it was a business-wide effort that tapped individuals at numerous levels.

She started by looking at her current quality and accreditations team within Caremark.

"In working with them, there was an advantage because these are individuals who understand at a reasonably high level the quality work that takes place across CVS Health," she pointed out.

But given the extensive URAC accreditation requirements, Gourdine knew she'd also have to pull in other experts from across the CVS business. She tapped colleagues at CVS Specialty Pharmacy based on their areas of expertise and how they aligned with the accreditation standards.

"It was similar to the process that we used in achieving other accreditations across the enterprise," she noted. "My team was experienced in walking through that process and understanding what needed to be done."

There was also an educational component to team-building, Gourdine acknowledged. More specifically, she needed to educate folks across the enterprise about health equity, helping them to understand how the work they do each day builds upon the company's overall health equity goals.

"As we were going through that process, one of the biggest challenges was to ensure that each individual who was engaged in this work actually was aware that they were engaged in this work," Gourdine recalled.

"We have a definition at CVS Health saying that health equity is making sure that every individual has a fair and just opportunity to be as healthy as possible," Gourdine said. "That's the standard definition, but sort of taking that down one level further to an individual and saying, what does that mean in terms of the work that I do, is something that going through this process allowed us to do."

Staff education was an empowering process, she added, because it gave a broader, more meaningful context to an individual's daily workload.

"Once those light bulbs went off, it was really exciting for people to understand just how much we do in support of the people that we work for every single day," Gourdine said.

That satisfaction was compounded when CVS Health became the first company to achieve the URAC accreditation, Gourdine said. Indeed, there was a personal component to that achievement, as she described health equity as a guiding philosophy for her career in clinical practice.

"I understand that for some people, the journey to good health is much more difficult than others," she said. "Bringing that attitude into this organization was actually pretty easy because the individuals who work in our organization are really committed to the work that we do."

On an organizational level, the URAC accreditation has been a key step forward and forging the overall healthcare industry's path toward equity for all.

"What does this mean to our organization to be first? It really does sort of cement us, I believe, as an industry leader that's committed to upholding and delivering equitable care," Gourdine concluded. "When we say that we have a commitment to help peoples' journey to better health, to be able to sit down and really evaluate what that means for people is something that this health equity accreditation journey allowed us to do."

Sara Heath has covered news related to patient engagement and health equity since 2015.