New York’s recently enacted law requiring healthcare providers to evaluate the health equity impact of proposed construction or renovation projects creates an avenue to address longstanding disparities in care delivery. Hospitals, nursing homes, birthing centers, ambulatory surgery centers, and most diagnostic and treatment centers are now mandated to commission Health Equity Impact Assessments (HEIA) as part of the certificate-of-need review process.
While some critics bemoan the additional red tape, proponents of the law say it’s intended to curb the concentration of facilities investments in affluent areas that are already well-served by the healthcare system – and encourage development in medically underserved communities. Embracing the law won’t come without its challenges, but doing so will enable New York hospitals to advance growth that is both profitable and equitable.
Navigating Regulatory Scrutiny and Community Distrust
Under the new guidance, healthcare institutions that are singularly focused on profit maximization are likely to face greater scrutiny by regulators. For instance, with the growing interest of private equity funders in healthcare, it’s become common practice for hospitals to streamline services and prioritize private payer populations. Over the past two decades, many of the nation’s largest nonprofit hospital systems have divested or closed sites in low-income areas. While the law does not prevent healthcare systems from undertaking profitable projects – or dropping unprofitable lines of service – it does demand that they meaningfully address health disparities and deliver equitable community benefit. Failing to do so can result in stalled or halted projects.
Bridging the trust gap that divides providers and medically underserved patient groups will be another challenge – especially given the HEIA’s emphasis on community engagement. Sixty-nine percent of residents from ethnic minority groups, 70% of people in the LGBTQ+ community, and 77% of people with disabilities say their experience with the healthcare system has damaged their trust. This distrust is particularly acute in New York City where residents of the poorest neighborhoods are twice as likely to die earlier in life than those who live in wealthier areas.
That’s where Ichor comes in.
Prioritizing Data-Informed Engagement
Overcoming regulatory barriers to expansion and building trust with vulnerable communities requires proactive engagement, active listening, and sustainable solutions.
Unlike other consultancies, Ichor is embedded in diverse communities, uniquely enabling us to reach underserved patient populations and other key stakeholders and help health systems advance more equitable service expansions.
We’re equipped to support healthcare institutions at each phase of the HEIA process outlined by the New York State Department of Health, as well as beyond:
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Scoping: Using data to identify communities likely to be impacted by a proposed project.
Our research analysts can work closely with healthcare institutions to identify affected populations.
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Potential Impacts: Identifying positive and negative health outcomes of a proposed policy or program.
Our engagement experts can conduct listening sessions and other interviews with community stakeholders to collect key insights regarding potential health impacts. We can supplement this data with quantitative analyses regarding disproportionate health outcomes or potential cumulative impacts on communities facing inequities.
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Mitigation: Identifying evidence-based methods to reduce potential negative impacts and amplify positive impacts.
We can leverage our in-house equity expertise, as well as research on best practices, to identify holistic, evidence-based approaches for minimizing negative health impacts and enhancing positive ones.
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Monitoring: Establishing and measuring mitigation strategies for affected groups.
Our team would work closely with the client and the impacted communities to co-develop project-specific mitigation strategies and devise a measurement framework to monitor and evaluate these efforts over time and iterate as needed.
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Dissemination: Sharing findings and equity recommendations.
Finally, we can work with healthcare institutions to communicate findings and recommendations to all important stakeholders – communities and policymakers alike – in an accessible manner.
Delivering Health Equity
The landmark health equity law enables New York providers to serve as a model for other systems across the country. In addition to improving community health outcomes and building greater trust, the tangible benefits for healthcare systems that embrace the spirit of the HEIA process – and place equity at the heart of expansion efforts – include mitigating regulatory and legal scrutiny, limiting costly disruptions to project timelines, and preserving tax benefits.
Contact the Ichor team today to discuss how we help clients advance more equitable health outcomes.
