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Published on March 29, 2022

Billings Clinic named Top Performer in Human Rights Campaign Foundation’s 2022 Healthcare Equality Index

Billings Clinic is one of just 251 health care organizations nationwide to receive the “LGBTQ+ Healthcare Equality Top Performer” designation

WASHINGTON— Billings Clinic is pleased to announce that it has received an evaluation of 85 out of 100 and the designation of “LGBTQ+ Healthcare Equality Top Performer” in the Human Rights Campaign Foundation’s 15th anniversary edition of the Healthcare Equality Index (HEI). The HEI is the nation’s foremost benchmarking survey of health care facilities on policies and practices dedicated to the equitable treatment and inclusion of their LGBTQ+ patients, visitors and employees. A record 906 health care facilities actively participated in the 2022 HEI survey and 251 of those, including Billings Clinic, earned an “LGBTQ+ Healthcare Equality Top Performer” designation.

“This designation is a commitment to our patients, our staff, and our community at large that we will meet each person where they are, as who they are, whenever they seek care from our teams,” said Sarah Hall, Co-Chair of the Billings Clinic LGBTQ+ Committee. “Creating a culture at Billings Clinic where everyone feels safe is not something we can achieve in a day, or a year, but something we must actively practice. These efforts will never truly be finished, and we are excited to see how this practice will evolve moving forward.”

Billings Clinic is one of just two health care organizations in Montana and Wyoming participating in the HEI. As an organization, it participated in the HEI since 2017 and has worked consistently to meet its standards, continue to enhance policies and practices, and improve upon meeting the needs of LGBTQ+ patients, guests and employees. This involves a broad scope, including internal policies, staff education, public involvement and connections, record keeping, care services and others.

This work is one component of a broader and continuous organization-wide commitment to Diversity, Equity, Inclusion and Belonging for patients, their families and employees.

“Every person deserves to have access to quality health care, be respected and heard by their doctor, and feel safe in the facility where they are receiving care. But LGBTQ+ people are often subject to discrimination in all spaces, including health care facilities, which leads to members of the community avoiding care and anticipating our voices will not be respected in an incredibly vulnerable environment,” said Tari Hanneman, Director of Health & Aging at The Human Rights Campaign. “The Healthcare Equality Index, at its core, strives to ensure LGBTQ+ people are protected and affirmed by their health care providers and feel safe seeking services. Our HEI active participants are truly pioneering the health care industry by implementing robust, comprehensive LGBTQ+ inclusive policies that hopefully, because of their work, will become standard practice.”

The HEI evaluates and scores health care facilities on detailed criteria falling under four central pillars:

  • Foundational Policies and Training in LGBTQ+ Patient-Centered Care;
  • LGBTQ+ Patient Services and Support;
  • Employee Benefits and Policies; and,
  • Patient and Community Engagement.

In the 2022 report, an impressive 496 facilities earned HRC’s “LGBTQ+ Healthcare Equality Leader'' designation, receiving the maximum score in each section and earning an overall score of 100. Another 251 facilities earned the “Top Performer” designation with scores between 80 to 95 points and at least partial credit in each section. With 82% of participating facilities scoring 80 points or more, health care facilities are demonstrating concretely that they are going beyond the basics when it comes to adopting policies and practices in LGBTQ+ care.

The remarkable progress reflected in the 2020 HEI includes:

  • 93% of participants met the HEI's training requirements, completing more than 200,000 hours of staff training in LGBTQ+ patient-centered care.
  • 82% of participating facilities earned either the Leader or Top Performer.
  • 99% of HEI participants documented that they include both “sexual orientation” and “gender identity” in their patient non-discrimination policy.
  • 99% of HEI participants documented that they include both “sexual orientation” and “gender identity” in their employment nondiscrimination policy.
  • 81% of HEI participants offer transgender-inclusive health care benefits to their employees, up from 75% in 2019, which was the first year that it was required to receive Leader status.

“We are proud of the growth we have seen at Billings Clinic in LGBTQ+ patient care,” Sara Agostinelli, Director of Diversity, Equity, Inclusion, and Belonging. “While the recognition is exciting, we also know this is an important reminder of work we must continue to focus on in the future. We know there have been harms to the LGBTQ+ community across health care, and even now, know we have work to do to continue to remove barriers for our LGBTQ+ patients. We are committed to this ongoing journey and making health care accessible for everyone in our community”

In addition to active survey participants, the HRC Foundation proactively researched the key policies for LGBTQ+ inclusion at over 1,300 non-participating hospitals. These research hospitals were much less likely to have LGBTQ+ non-discrimination policies in place, which is a stark contrast to the near-perfect adoption by active participants. Among the researched hospitals in which the HRC was able to find or obtain enumerated patient non-discrimination policies, only 70% have policies that include both sexual orientation and gender identity compared to 99% of HEI participants.


The Human Rights Campaign Foundation is the educational arm of the Human Rights Campaign (HRC), America's largest civil rights organization working to achieve equality for lesbian, gay, bisexual, transgender and queer (LGBTQ+) people. Through its programs, the HRC Foundation seeks to make transformational change in the everyday lives of LGBTQ+ people, shedding light on inequity and deepening the public’s understanding of LGBTQ+ issues, with a clear focus on advancing transgender and racial justice. Its work has transformed the landscape for more than 15 million workers, 11 million students, 1 million clients in the adoption and foster care system and so much more. The HRC Foundation provides direct consultation and technical assistance to institutions and communities, driving the advancement of inclusive policies and practices; it builds the capacity of future leaders and allies through fellowship and training programs; and, with the firm belief that we are stronger working together, it forges partnerships with advocates in the U.S. and around the globe to increase our impact and shape the future of our work.

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