The lesbian, gay, bisexual, transgender, and queer (LGBTQ) population deals with complex medical and behavioral issues coupled with barriers in accessing both healthcare and health insurance leading to poorer health outcomes as compared with the general population. Because this community is often overlooked in efforts to improve minority health disparities, in 2007, the Human Rights Campaign Foundation introduced the Healthcare Equality Index (HEI) for evaluating healthcare facilities' policies and practices related to the equity and inclusion of their LGBTQ patients, visitors, and employees. This study's aim was to determine whether the LGBTQ Healthcare Equality Leader institution designation advantage found by DiLeo et al (2020) has a continuing positive effect on Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) performance. We found that patient scores for both Overall Rating and Willingness to Recommend were higher with noted improvement for HEI Leader institutions as compared with non-HEI Leader institutions over this study's 3-year period. Based on the findings of this study, it can be implied that hospitals do receive a return on their investment for achieving or maintaining the HEI Leader designation and this investment benefits all populations served by the organization inferred by their maintained higher patient experience scores.

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