The Blue Cross Blue Shield Association (BCBSA) and the National Minority Quality Forum (NMQF) are calling on the healthcare industry to adopt a health equity-focused approach to social determinants of health (SDOH) data collection. The two organizations have developed guidelines that include establishing clear requirements for collecting race, ethnicity, language and sexual orientation and gender identity data. They are also advocating for the mandatory adoption of new data collection standards by all government agencies and private sector healthcare stakeholders.
Blue Cross Blue Shield Association (BCBSA) and the National Minority Quality Forum (NMQF) have called for 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.
The collection of 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. Health experts have also emphasized that the adoption of standardized SDOH screening tools and uniform data standards is essential to facilitate interoperability.
Kim Keck, President, and CEO of BCBSA stated, “Data is more than numbers—it represents people. Our data must be as diverse and inclusive as our nation’s population. Standardized, precise data provide opportunities for insurers, healthcare 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However, SDOH data collection is not comprehensive and is outdated, contributing to the growing health equity gap. 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 have suggested several guidelines be incorporated into the updated directive.
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.
Gary A. Puckrein, MD, President, and CEO of NMQF stated, “High-quality, reliable data are essential to understanding where and how health disparities arise. 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.”
The need for standardized SDOH data collection has become increasingly apparent in recent years as healthcare organizations have sought to address health disparities among historically marginalized communities. By collecting and analyzing data on race, ethnicity, language, sexual orientation, and gender identity, healthcare organizations can identify disparities and design targeted interventions to improve health equity.
However, the lack of standardized data collection has hindered efforts to address health disparities. Current data collection methods are often inconsistent, incomplete, and outdated. Standardizing SDOH data collection would not only facilitate interoperability but also provide healthcare organizations with a comprehensive and accurate picture of health disparities across the country.
