Health Equity and Access Weekly Roundup: June 1, 2024

From Polypharmacy to Personalized Care: Dr Nihar Desai Discusses Holistic Cardiovascular Care

In this episode of Managed Care Cast, Nihar R. Desai, MD, MPH, vice chief of cardiology at the Yale School of Medicine, joined The American Journal of Managed Care^® (AJMC^®) to talk about critical topics in managing cardiovascular disease. He highlighted the importance of patient education, shared decision-making, and addressing cost and access barriers. Desai also explored multiple innovative strategies such as behavioral economics, personalized medicine, and digital tools to improve adherence.

Understanding the Complexities of Equity Within the Emergence and Utilization of AI in Academic Medical Centers

For successful integration of artificial intelligence (AI) in academic medical centers, ethical considerations such as explainability, responsible AI, and equitable use must be addressed, according to authors Timethia J. Bonner, DPM, PhD and Prasaad Ayyanar, MS. Ensuring diversity in AI development teams and the data used is crucial to prevent biases and enhance generalizability and must promote health equity by reducing disparities and fostering fairness. The impact on clinical decision-making and patient trust depends on transparent and responsible AI use, they wrote.

Racial Disparities in Hospitalizations, ED Visits Among Medicaid-Enrolled Children With Asthma

A new study published in the American Academy of Pediatrics found significant racial disparities in hospitalizations and emergency department (ED) visits for asthma among Black children compared with White children enrolled in Medicaid. Using Medicaid claims data from 2018 to 2019 for 279,985 children across 10 states, researchers revealed that Black children had substantially higher rates of hospitalizations and ED visits for asthma than White children, even after adjusting for various factors. The authors suggested that these disparities are linked to broader issues such as access to high-quality outpatient care, discriminatory treatment, and exposure to asthma triggers.

Equity and AI Governance at Academic Medical Centers

Research published in AJMC examined how equity is integrated into AI/machine learning governance at academic medical centers through qualitative interviews with 17 individuals from 13 institutions. The findings revealed that most participants focused on algorithmic bias and fairness within the technology itself, with fewer considering broader equity implications for patients. Disparities in health IT resources were seen as a significant threat to health equity, the authors noted. Despite growing awareness of potential inequities caused by predictive technologies, consistent consideration of equity in governance processes is lacking.

New Data Standards and Collection Methods Detailed at CMS Health Equity Conference

At the 2024 CMS Health Equity Conference, key leaders from CMS and CDC discussed significant advancements in data collection aimed at promoting health equity. The speakers explored the addition of optional sexual orientation and gender identity questions to the Marketplace application. Emphasizing a team-based approach across initiatives, the critical role of comprehensive, standardized data in driving improvements and ensuring equitable care was highlighted.