About Us

Achieving health and healthcare equity can seem like a jigsaw puzzle; it has multiple, interdependent pieces that must snap into the right place to achieve the best result. Unlike the versions we assemble on our coffee tables and kitchen islands, solving the puzzle of health equity is not something we can do for a few minutes each day. Ensuring that all people regardless of identities such as their race, class, gender, sexuality, or religion can live their healthiest life possible requires dedicated teams of people and organizations working together. It requires focusing not just on the day-to-day work of administering care, but also on changing all the structures in the healthcare system that allow inequity to fester.

For more than 18 years, the RWJF Advancing Health Equity: Leading Care, Payment, and Systems Transformation program (AHE) and its predecessor, Finding Answers, have been national leaders in driving meaningful changes that move key stakeholders in the healthcare system away from merely documenting health inequities toward implementing solutions.

• Lay the groundwork for how to address health inequities
• Create team and organization-wide cultures of equity
• Identify health equity focus areas
• Diagnose the many causes of specific health and healthcare inequities
• Design and implement sustainable models of care and payment

AHE is guided by its comprehensive Roadmap to Advance Health Equity. The Roadmap, originally developed in 2012 as AHE’s guiding framework, integrates the creation of a culture of equity with the technical steps required for organizations to identify inequities, determine the root causes of those inequities, and design and implement care delivery interventions and payment models to support and sustain them.

From its inception in 2005 as Finding Answers: Disparities Research for Change, to its current iteration as Advancing Health Equity: Leading Care, Payment, and Systems Transformation, our focus has been on helping organizations eradicate health and healthcare inequities and nurture healthier people, communities, and states step by step, one piece at a time. Please click here for more information about the AHE program.

Application of Key Concepts to the Work of AHE

Everyone should have access to high quality healthcare so that they can achieve their optimal health.  That requires fixing structural barriers so that equal opportunities to achieve optimal health work in practice. Addressing barriers to high quality healthcare is about identifying all types of inequities, including but not limited to racial, geographic, and disability related.  After barriers to quality healthcare are identified, organizations must conduct root cause analyses with an equity lens to determine why the barriers exist and then design and implement care and payment transformations to address the root causes.

This work requires many individuals, multiple teams, and sometimes multiple organizations to collaboratively engage in complex systems-level innovation and change processes.  The potential to successfully advance health and healthcare equity increases under the influence of different points of view belonging to people with different sets of experiences.  Settings that nurture diversity of thought and experience strengthen our capacity to design and implement transformational interventions that advance the quality of healthcare for everyone.  Indeed, most of the existing inequities in the quality of healthcare that people receive can be traced to the fact that healthcare systems have historically been designed and maintained within a context of limited diversity of thought and experience.

Fostering a diverse and inclusive climate within health sector organizations and the teams within them promotes rigorous inquiry and increases the likelihood that incorrect assumptions will be questioned—a key step towards field-defining advancements in health equity research and discovery. This principled conception of the role of diversity is intertwined within Advancing Health Equity’s commitments to its values, free expression and the University of Chicago’s commitment to academic freedom.  This is why Creating Cultures of Equity that attend to power structures and processes that inhibit free expression, full participation, and inclusion is a bedrock principle infusing all of our work. The possibility of enhanced discovery that diversity enables can only be realized when assumptions are questioned and when openness to hearing about the health and healthcare journeys of others and their opinions is genuine.  Thus, we need to partner closely with those who are living with the health and healthcare inequities that we attempt to reduce and eliminate.

It is for these reasons that we promote a culture of free expression and equity within our own team and the health sector organizations and research environments in which we work.

We remain attentive to and address instances of bias and exclusion that diminish the potential of reaching our goal of a healthcare system where everyone thrives, so that we may successfully eliminate health and healthcare inequities that undermine our healthcare system and harm the wellbeing of our country.

Marshall Chin, MD, MPH
Richard Parrillo Family Distinguished Service Professor of Healthcare Ethics
Department of Medicine
University of Chicago

Scott Cook, PhD
Department of Medicine
University of Chicago

Integrating Payment and Health Care Delivery Reforms to Achieve Health Equity

Most organizations need a strong business case to justify the time and energy needed to sustainably address disparities in patient care and health outcomes. Payment reform may be a solution, but payers and health care organizations are unsure how to design payment models that support and incentivize achieving health equity. In 2014, we funded three grantees that aimed to reduce disparities through care transformation and payment reform.

Aligning Key Stakeholders to Achieve Health Equity

The activities of policy makers, payers, enrollees, communities, and healthcare delivery organizations to achieve health equity must be aligned if they are to be effective. We currently partner with three organizations: the Center for Health Care Strategies, the Institute for Medicaid Innovation and The Justice Collective. Our partnership helps us collaborate with state Medicaid agencies, Medicaid managed care health plans, and healthcare delivery organizations. It is focused on designing value-based payment and contracting models that support and incentivize healthcare delivery transformation to reduce and eliminate disparities in health and healthcare. 

The tools on this website capture the program’s main lessons learned and best practice recommendations so that health care and payer organizations can successfully reduce disparities via quality improvement and payment reform efforts.

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“Linking incentives to outcomes helped promote a team approach to patient care and also inspired some healthy competition between the three clinic sites. After only a year of implementation, the researchers started to see significant differences in clinical quality metrics across the three locations… Staff continue to be committed to reducing disparities and improving the health of our patients.”

Robin Mullet, acting program director at Fairfax County Health Care Network