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Reality Check: Where C-Suites Say Healthcare is Making Progress Advancing Equity — and Where Momentum Slowed Since 2022

By Sage Growth | February 13, 2024

In response to the convergence of macroeconomic conditions and health inequities that rose into the national discourse during 2020, healthcare leaders and policymakers have been calling out the need to advance equity. 

From technology companies to health plans and health systems, many enterprises appointed their first Chief Health Equity Officer. [1] The Biden Administration’s budget includes: $150 billion to expand access to quality affordable care, as well as additional funding to support rural health, maternal health, and to address housing discrimination, treatment of infectious diseases among underserved populations, and people experiencing homelessness. [2] The U.S. Department of Health and Human Services issued its equity action plan, [3] and the U.S. Centers for Medicare and Medicaid Services released a framework to advance equity, expand coverage, and improve outcomes for some 170 million Americans who participate in its programs. [4]

Key aspects of advancing health equity are increasing access to care, focusing on the social drivers that impede the delivery and equity of healthcare, and lowering overall costs of care. To understand which aspects of the healthcare industry – health systems, health plans, federal and state governments, big tech – are making progress on those fronts and where they are stalling, we asked 108 hospital and health system executives in the annual Sage Growth Partners C-Suite survey.

Many C-Suite leaders say healthcare as an industry is making less progress increasing access to care in 2023 than in 2022. Only 5% more say the industry has become better at lowering costs than last year. On the upside, 11% more indicate that progress is being made in reducing existing inequities than in 2022. 

Drilling down into specific sectors, C-Suite executives told us that hospitals and health systems are making the most progress within healthcare again in 2023 — but that is not to say any segment of the industry is making definitive progress. In 2023, 19% of survey respondents say hospitals are either “very effective” or “extremely effective” at moving toward equitable and sustainable healthcare, down from 21% in 2022. Following health systems are retail clinics at 12%, compared to 13% in 2022.

C-Suite leaders view state governments as notably less effective in 2023 than 2022: 9% vs. 21%. The federal government, for its part, is seen as “very effective” or “extremely effective” by only 8% of survey respondents in 2023, up from 5% in 2022. Executives also rate big tech disruptors just as they do the federal government in 2023: 8% say “very effective” or “extremely effective,” up from 6% in 2022. 

Given that 69% of survey respondents rank lowering total costs of care (the same percentage as in 2022) and 43% say improving access to care (up from 24% in 2022) are among their greatest challenges, hospital and health system C-Suites are moving in that direction but still have a lot of work ahead to meaningfully advance health equity. 

Download our full research report, The New Healthcare C-Suite Agenda: 2024-2025, to learn more about top strategic considerations, where healthcare organizations are investing in technology to achieve those, how EMRs are still failing to deliver on vendor promises, clinical and operational use cases for AI and where hospitals are exploring new ways to leverage AI, and more. 



  1. The rise of the chief health equity officer, America’s Health Insurance Plans 
  1. Fact sheet: President Biden’s budget advances equity, The White House 
  1. HHS Equity Action Plan, The U.S. Department of Health and Human Services 
  1. CMS Framework for health equity 2022-2032, The U.S. Centers for Medicare and Medicaid Services