Form CMS-10866 CMS Health Equity Nomination Form

CMS HEALTH EQUITY AWARD
Call for Nominations
CMS is excited to announce the Call for Nominations for the CMS Health Equity Award. Equity is a key
component of high-quality healthcare. Health equity is defined by Healthy People 2030
https://health.gov/healthypeople as the attainment of the highest level of health for all people. A measure
of health equity is the reduction or elimination of disparities in health that adversely affect vulnerable
populations. CMS recognizes the importance of health equity and is working to ensure that disparities in
health care quality and access are eliminated. You can visit the CMS Office of Minority Health website to
learn more about some of the efforts underway.
Starting in 2018, CMS began recognizing organizations who have demonstrated a strong commitment to
health equity by reducing disparities affecting vulnerable populations such as racial and ethnic
minorities, individuals with disabilities, sexual and gender minorities, and those living in rural areas.
Continuing the focus, the CMS Health Equity Award will shine a light on an organization leading the way
on the path to equity, showing others how to reduce disparities in quality, access, and outcomes.
Please read the criteria and complete one Nomination Form per nominee for the CMS Health
Equity Award. All Nomination Forms should be submitted to the CMS Office of Minority Health
(ATTN: CMS Health Equity Award, [email protected]) no later than TBD. Questions about
the award can also be submitted at this mailbox.
WHO IS ELIGIBLE
All CMS partner/stakeholder organizations and networks, at the organizational level, are eligible for the
award. This includes QIN-QIOs, BFCC-QIOs, HIINs, TCPI Networks, ESRD Networks, Hospitals, State
Medicaid Agencies, Health Plans, Model Participants, Provider Groups and Organizations, and all other
organizations who work with CMS beneficiaries and their providers.
CRITERIA
This award will go to an organization that can demonstrate that they have reduced disparities in health
care quality, access, or outcomes between two or more groups. Populations of focus, include racial and
ethnic minorities, people with disabilities, sexual and gender minorities, and rural populations. More
information about past awardees can be found at https://www.cms.gov/About-CMS/AgencyInformation/OMH/equity- initiatives/equity-awards.html.
AWARD
CMS will assess each application through a competitive process to identify the organization that has had
the greatest impact on health equity. One entity will be awarded in early 2025; additional awardees may
be selected at the discretion of CMS.

NOMINATION FORM
CMS Health Equity Award
All Nomination Forms are due to CMS Office of Minority Health (ATTN: CMS Health
Equity Award, [email protected]) no later than TBD.

Organization Name
Project Name
Nominator Name
Project Lead Name
CEO Name

Email
Email
Email

Please provide a brief description of your organization’s health equity project, including the specific disparity
addressed (1000 words max).

Please provide a summary (e.g. description, graphs, dashboard, map) of your results and an explanation of your
evaluation methodology. (1000 words max)

For example:
- There was a difference in the rates of African Americans and Whites in cardiac rehabilitation rates – African
Americans had a rate of x and Whites had a rate of y. Based on the intervention of Organization A, the gap in
rates was reduced by z.
- After stratifying their data, Organization B noted that individuals whose preferred spoken language was Spanish
or Korean had higher readmission rates compared to those whose preferred language is English. Upon further
exploration, they identified several causes for the disparities including a lack of resources in languages other than
English. After implementing an initiative to address several of the root causes and analyzing their results,
Organization B found readmission rates decreased by xx percent, resulting in a y percent decrease in the initial
disparity.

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