The United States of America is an incredibly diverse country—but healthcare providers haven’t always done the best job of meeting the needs of this varied population. Despite the best efforts of many major providers, there are still numerous communities and groups of people who find themselves underserved by the country’s current healthcare landscape.

These people are now becoming the focus of the Centers for Medicare & Medicaid Services (CMS). CMS has long placed emphasis on underrepresented groups in the healthcare industry, but at its 2nd CMS Health Equity Conference on May 29th and 30th of this year, the organization reiterated its commitment to “sustaining health equity through action.”

In this piece, we’re going to go over just how CMS plans to do this, changes providers can make to reach these goals, and what issues may continue to present themselves as CMS undergoes this difficult endeavor.

Over the course of the conference, various officials discussed the ongoing troubles the US has with substance use disorder and how this is affecting the current healthcare landscape. The prevalence of this disorder, alongside issues related to mental health, has become a major risk factor in pregnancy, noted CMS Administrator Chiquita Brooks-LaSure.

Access to care was another great topic of conversation at the conference, indicating a potential larger focus for CMS in the coming months. Attendees discussed how telehealth options could be improved for those with disabilities, how care could be optimized for patients by removing burdens from administrators, and how health equity could be measured in order to make secure the programs that work, and revise or eliminate those which do not.

The topics discussed at this conference represented just how seriously CMS appears to be taking the topic of better representing and assisting those who are underserved by the country’s current medical system.

This commitment is furthered by CMS’ recently updated Framework for Health Equity, which can be found on its website. According to the site, “the framework sets foundation and priorities for CMS’s work strengthening its infrastructure for assessment, creating synergies across the health care system to drive structural change, and identifying and working to eliminate barriers to CMS-supported benefits, services, and coverage.”

The Framework is filled with details about how various communities can be better served by healthcare providers, with resources provided for manifold groups that include information provided by group members themselves on how their treatment from providers could be improved. Among these groups are people in rural communities, those with limited English proficiency, people with disabilities, members of the LGBTQIA+ community, and more.

Furthermore, CMS has offered a toolkit to assist companies in adhering to the standards for delivering culturally and linguistically appropriate services, as well as endorsing a screening tool for providers to use with their patients to identify social needs that may significantly impact their interactions with the healthcare system.

These are noble goals; however, there are certain issues that could make the full realization of these goals difficult.

For example, while LGBTQIA+ people may be legally protected from discrimination under the Affordable Care Act, the recent spat of anti-LGBTQIA+ legislation that has been making its way through local and state governments could make it more difficult for people in this community to access care, even with CMS’ efforts. A 2017 study from the Center for American Progress found that discrimination discourages LGBTQIA+ people from seeking care, and that people in this community “may have trouble finding alternative services if they are turned away.”

Concerning those in rural communities, while improving services like telehealth may provide better health outcomes, they still face a growing issue of having little health infrastructure to resolve more serious issues. As noted by Greg Gilpin for Montana State University, there have been “over 100 rural hospital closures and 87 conversions to urgent care facilities since 2005.”

No matter the potential problems that may arise along the way, CMS’ intentions with this framework and the discussions that surround it could pave the way for a brighter future in American healthcare. We will continue to update you as this program is implemented.