CMS-10866 CMS Health Equity Scoring Rubric

CMS Health Equity Award – Scoring Sheet
Organization Name:
Health Equity Activity:
REVIEWER NAME:
Category
Disparity Among Priority Population
Organization addressing a disparity among a
priority population:
- Racial/ethnic minority (includes LEP)
- Sexual/gender minority
- Individuals with disability
- Individuals living in a rural or underserved
area
Health Equity Activity
Activity/activities submitted is clearly linked to
increase health equity and reduce disparities.

TOTAL SCORE (OUT OF 50, 55 MAX – 5 bonus points):
Possible Points
0: did not address a disparity
2: addressed a disparity, but not
among a priority population
5: addressed a disparity among
priority population
Total Possible Points: 5

Instructions on Scoring and Justification
Rate anywhere between 0-5 using the criteria as
guides. Include any comments to justify score
below:

0: not related to health equity
5: seems related to health equity
but link is weak/unclear how it will
reduce disparities
10: health equity activity is planned
but not off the ground yet
15: activity is clearly designed to
reduce disparities
Total Possible Points: 15

Rate anywhere between 0-15 using the criteria as
guides. Include any comments to justify score
below:

Category
Results
Organization demonstrates results of reducing
a disparity in health care quality, access, or
outcomes.

Bonus Points
Organization’s efforts include community,
patient and family, and stakeholder input and
engagement.
Organization focused on one or more CMS
Quality Strategy area or other CMS priority:
1. Make Care Safer by Reducing Harm;
2. Strengthen Person and Family
Engagement;
3. Promote Effective Communication and
Coordination of Care;
4. Promote Effective Prevention and
Treatment of Chronic Disease;
5. Work with Communities to Promote
Best Practices of Healthy Living; and
6. Make Care Affordable

Possible Points
0: no results discussed, preliminary
or otherwise
10: results discussed but too early to
report
20: results described qualitatively,
but not quantified/measurable
30: measurable, quantified results
reported
Total Possible Points: 30
0: no link to CMS priority
1: community somewhat involved
2: community fully engaged
3: can link efforts to a CMS Quality
Strategy priority or other CMS
priority
Total Possible Points: 5

Instructions on Scoring and Justification
Rate anywhere between 0-30 using the criteria as
guides. Include any comments to justify score
below:

Note scores based on criteria. Include any
comments to justify score below:

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