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BCBSA Offers Health Equity Guide to Standardized SDOH Data Collection

Old SDOH data collection methods can exacerbate disparities; BCBSA and NMQF have called on the healthcare industry to close health equity gaps through standardization and updated approaches.

Blue Cross Blue Shield Association (BCBSA), in partnership with the National Minority Quality Forum (NMQF), has urged the healthcare industry to adopt a health equity-focused set of recommendations to improve the standardized approach to social determinants of health (SDOH) data collection.

Collecting race, ethnicity, language (REL) data and sexual orientation, and gender identity (SOGI) data is crucial for identifying health disparities among historically marginalized communities and facilitating evidence-based health equity interventions.

Moreover, health experts have contended that the adoption of standardized SDOH screening tools and uniform data standards is essential to facilitate interoperability.

"Data is more than numbers—it represents people. Our data must be as diverse and inclusive as our nation's population," Kim Keck, president and CEO of BCBSA, said in a press release. "Standardized, precise data provide opportunities for insurers, health care providers, and patient advocates to design and implement targeted health solutions to better meet the needs of disproportionately impacted communities. Through the adoption of comprehensive data collection standards, we can address health inequities head on and create a better system of health for all Americans." 

However, SDOH data collection isn’t comprehensive and it’s outdated, contributing to the growing health equity gap.

So, while data standards like Statistical Policy Directive No. 15 exist, they have not been updated for almost three decades. In 1977, the Office of Management and Budget (OMB) introduced Statistical Policy Directive No. 15, which set a benchmark for accessing information from different agencies and evaluating the efficacy of minority-focused federal programs.

By the summer of 2024, OMB plans to initiate a formal review process, nearly thirty years after it introduced Directive No. 15. BCBSA and NMQF suggested that several guidelines be incorporated into the updated directive.

These guidelines include establishing clear and consistent requirements for REL and SOGI data collection, as BCBSA and NMQF mentioned.

Primarily, the organizations recommended that the requirements adhere to a minimum standard for disaggregated race/ethnicity collection and align with industry interoperability standards.

Furthermore, OMB should integrate the current data standards proposed by the Department of Health and Human Services (HHS) Assistant Secretary for Planning and Evaluation/Office of Minority Health into Directive No. 15.

Additionally, the updated standards should be mandated as the minimum criteria for collecting disaggregated REL data.

BCBSA and NMQF recommended that OMB seek and consider input from a diverse range of stakeholders regarding SOGI data collection and utilization when updating Directive No. 15.

Finally, upon the release of the updated OMB Directive No. 15 in 2024, the OMB has been encouraged to enforce mandatory, uniform, and universal adoption of the new standards for all government agencies and private sector healthcare stakeholders, including payers and providers.

"High-quality, reliable data are essential to understanding where and how health disparities arise," said Gary A. Puckrein, MD, president and CEO of NMQF. "Sufficiently collecting and exchanging data requires a multi-stakeholder approach and we look forward to working with players in the public and private sectors to establish a robust set of data standards and ultimately reduce health equities in the United States."

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