Business needs push health equity back to the fore in 2026

Looking back on health equity's 'rise'

The term "health equity" arguably reached buzzword status in 2020, although the work of achieving equitable health outcomes has been underway for a while. Jain himself first learned about health equity and health disparities during an undergraduate class in health policy and again heard about them during medical school.

"And then, for a period of time, we went from documenting disparities to looking at how we might be able to close those disparities," he said.

Tailoring diagnostic approaches, supporting culturally competent and responsive care and integrating social determinants of health work became commonplace, especially given the rise of value-based care contracts. In order to be successful in those contracts, payers and providers needed to ensure good outcomes for all patients.

Those efforts reached a nexus point in 2020, when the U.S. was going through a larger cultural reckoning with race in the wake of George Floyd's murder as well as grappling with the COVID-19 pandemic.

"You had this twin challenge of a disease that was affecting certain populations and communities disproportionately, and you had public outcry over the murder of an African American man in Minneapolis," Jain explained. "The natural extension of that was that people in the healthcare industry stood up and took a stand. They made statements, they made commitments, they made proclamations, and in some cases, they appointed chief health equity officers."

The high premium put on health equity sparked a widespread industry movement, Jain added, as more influential healthcare players launched entire health equity initiatives and implemented required cultural competence training courses.

At the national level, the Centers for Medicare and Medicaid Services (CMS) launched a health equity index as a part of its star ratings system, while other programs within the agency also stressed health equity. As early as 2021, CMS was seeking public comment about how it could bake health equity into certain payment models, including the Physician Fee Schedule.

In April 2022, CMS issued a health equity strategy for all public payer programs. That's not to mention the numerous alternative payment models that were designed to consider health equity in provider payments.

For the folks who had been doing this work for decades, long before COVID-19 or George Floyd were dinner table conversations, the energy was heartening.

"For a moment, people who were in this field really felt like they were being seen and heard at the highest levels of healthcare," Jain explained. "People thought that this was moving in a particular direction."

"Enter 2024. President Trump gets elected, and the words are summarily erased from almost every kind of public governmental positioning."

Key health leaders recoil from 'health equity' work

It might not have come as a surprise that the Trump Administration would erase "health equity" from federal healthcare policy.

Take, for example, healthcare research initiatives. As part of the Department of Government Efficiency's campaign to cut spending, the government placed restrictions on the types of projects that could receive funding. Projects that mentioned health equity, or related priorities, got the axe, eliminating any potential for these programs to run.

"Interestingly, the private sector followed suit," Jain stated. "Before long, almost every chief health equity officer either found a new role in their companies or were laid off. A lot of the bold initiatives and claims that organizations were making in 2020 vanished without mention or concern."

In other words, organizations began to recoil from health equity work and instead embraced the idea that these initiatives are optional.

But many of the problems health equity initiatives tried to solve haven't gone away, Jain pointed out, laying the groundwork for these types of programs to make at least a modest comeback.

Will health equity work return in 2026?

As a Medicare Advantage plan, SCAN knows a thing or two about health outcomes -- and the disparities that exist across different sociodemographic groups.

According to Jain, 2025 saw persistent problems with health disparities, which have resulted in increased medical utilization and costs for managed care companies.

Thus, there's a business case to be made for health equity work, and it's going to get harder to ignore as payers and providers both face across-the-board hikes in medical expenditures.

SCAN has seen positive impacts from its own health equity work, paying off in more members and a broader provider network.

For example, the MA plan's LGBTQ+ health plan product has more than 3,000 members, which is "not an insignificant size health plan," Jain said. SCAN has also drawn in 10,000 members with a health plan tailored for Asian people and their unique health needs and culture.

And with SCAN Inspired, the company's plan focused on women's health, it's been able to expand its provider network.

"There were big health systems that otherwise were not contracting with SCAN," Jain noted. "When we indicated that we were trying to grow with a product that's focused on women, they suddenly said, 'yeah, we would like to contract with you. We like this idea.' And that led to broader business arrangements with those health systems, which has led to a lot of growth for us."

Jain predicted that more health systems and payers will follow suit, understanding not just the moral obligation to promote health equity, but the business imperative, too. It won't be a resounding return, Jain said to temper expectations, but health equity could make a modest comeback in the new year.

All of that can be made possible by a shift in public and political rhetoric, Jain added. There are more physicians serving in or running for Congress these days, he noted, and that's going to help shift the conversation back to equitable outcomes.

What's more, the healthcare C-suite is experiencing churn, as older incumbents reach retirement or move onto new opportunities. This will help when organizations face pushback on their health equity work, which Jain said even SCAN is not immune to.

"You have a new generation of leaders with different values coming into positions, and many of these folks are going to focus on these topics independent of where the political winds blow," Jain said. "There are some leaders who are stepping into their roles and who are going to say, 'we stand for what we stand for, and we're going to believe in what we believe in.' I do think that the changing of the guard is going to create a higher degree of focus on health equity."

For its part, Jain said SCAN also stands boldly in its work.

"We live in a very heterogeneous society, and we try to serve all people, but not everyone's going to like our approach to doing this business. We're okay with that, and we're proud of serving who we serve," he concluded.

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