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Advancing Health Equity Leading Care, Payment, and Systems Transformation

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.

AHE provides materials, training, and hands-on technical assistance to healthcare provider organizations and care teams, payer organizations, and government agencies. In addition, AHE’s Learning Collaborative works with teams of state Medicaid agencies, Medicaid health plans, frontline healthcare delivery organizations, Medicaid members, and communities to develop and implement  care transformation to advance—and achieve—health equity supported and incentivized by tailored payment models. We help teams:

  • 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.

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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“The program fills a critical gap in our nation’s efforts to reduce and eliminate disparities in health and healthcare. It will bring state Medicaid agencies, health plans, and providers together to learn best practices to address health disparities tailored to the needs of the people they serve.”

Andrea Ducas, MPH, senior program officer at the Robert Wood Johnson Foundation

“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