Curriculum Resource Center
Welcome to the AHE Curriculum Resource Guide (CRG), a comprehensive platform providing streamlined access to our extensive curriculum for advancing health equity. This guide is tailored to support both current AHE Learning Collaborative members and new users as they explore the tools and resources essential for driving impactful change within payment and healthcare delivery systems. The CRG offers an organized, structured approach to learning, designed to help you effectively navigate health equity-focused interventions and transformations.
As you progress through the CRG, we encourage you to approach each component sequentially. The curriculum is scaffolded, meaning that each section builds upon previous components, reinforcing and expanding on foundational principles. For instance, Foundational Activities and Essential Elements—two core AHE Roadmap Components—are woven throughout the entire curriculum. Completing each component thoughtfully and thoroughly is essential for maximizing the success of health equity interventions through payment and systems transformation.
The CRG serves as a practical, user-friendly resource hub to support your health equity journey. With in-depth learning modules and actionable tools, you’ll be equipped to design, implement, and sustain transformative efforts in healthcare. We are excited for you to delve into this resource and to partner with you in advancing equitable healthcare solutions.
Create Cultures of Equity
Efforts to reduce health and healthcare inequities are unlikely to succeed without a strong culture of equity. This goes beyond recognizing that inequities exist; it requires staff to see inequities as unacceptable and in need of change. Building such a culture takes time, collaboration, and continuous focus. In an equity-centered organization, employees actively work to understand and transform the dynamics that perpetuate health inequities.
While fostering a culture of equity can be challenging, the rewards are significant. When equity is a core value, staff embrace it as essential to the care they provide. Organizations with a commitment to equity also demonstrate respect for the diverse backgrounds of their workforce. Addressing inequities effectively means going beyond broad quality improvements. It requires awareness of specific inequities within one’s own patient population. Ultimately, a culture of equity is vital for any quality improvement effort created to close gaps in healthcare outcomes.
Create Cultures of Equity: A Critical Approach to Understanding Systems of Oppression
Create Cultures of Equity: A Critical Approach to Understanding Systems of Oppression is a two-part training that focuses on helping attendees learn more about how health equity impacts not just the individual receiving care, but also the care organization and its personnel as a whole. It details how national history, personal identity, and institutional approaches to health care impact the quest for health equity.
Create Cultures of Equity: Transforming Operations and Culture to Advance Health Equity
Create Cultures of Equity: Transforming Operations and Culture to Advance Health Equity is the second training in a two-part series that helps teams identify the roles roles and responsibilities involved in creating a culture of equity. Audiences will learn to pinpoint opportunities for partner organizations to advance health equity by transforming policies and procedures.
Identify a Health Equity Focus
Identifying a health equity focus is a complex process, especially in multi-organization collaborations where each entity has distinct perspectives and motivations influencing their preferences on which inequities to tackle. A good starting point is to assess the available data and determine the desired focus areas within the healthcare system.
Potential initiative focus areas may involve changes to policies and procedures across care provider organizations, health plans, state agencies, and community-based organizations. Initiatives can encompass multifaceted transformations in care delivery and payment systems, engaging some or all of these organizational types to effectively address health inequities.
Diagnosing Root Causes with an Equity and Anti-Racist Lens
A Root Cause Analysis (RCA) is a key tool in quality improvement, helping to uncover the underlying reasons for undesirable incidents. By identifying these fundamental causes, teams can implement changes to reduce the likelihood of recurrence. In healthcare, RCAs are commonly used to discover general quality improvement opportunities.
Techniques like process mapping, the “5 Whys,” and Cause-and-Effect Diagrams (e.g., Fishbone Diagrams) provide structured approaches for identifying and organizing potential causes of problems. By applying an “equity lens,” as described by AHE, RCAs can also highlight opportunities to address health and healthcare inequities. This lens acts as a filter, revealing issues that contribute to disparities in care quality and outcomes, ultimately guiding teams toward more equitable solutions.
Key Considerations: Conducting A Root Cause Analysis with an Equity Lens
The Key Considerations document lists several tips for what to adopt and avoid when conducting a root cause analysis. It also outlines the different levels of a health system and their influence on your potential healthcare delivery transformation.
Facilitator Guide: Diagnose Root Causes
The Facilitator Guide will help those using the Diagnose Root Causes PowerPoint manage the discussions, exercises, and reflections in the presentation. In addition to session goals and objectives, the guide lists the materials and pre-reading activities recommended for a successful session as well as a minute-by-minute breakdown of how a potential session could be structured.
PowerPoint Presentation: Diagnosing Root Causes with an Equity Lens
The Diagnose Root Causes PowerPoint presentation walks participants through what a root cause analysis (RCA) is and its various tools and uses. It illustrates how to use an RCA to identify multiple opportunities to reduce and eliminate health and healthcare inequities.
Prioritize Root Causes
By the end of the Root Cause Analysis (RCA), various causes of the targeted health inequity should be clear. The next step is to determine which root causes to prioritize for intervention through healthcare system transformation. The decision can be challenging, but focusing on the most specific root causes often reveals key drivers of inequities. In a fishbone diagram, these root causes are represented as the smallest branches, or “bones.”
If a diverse and knowledgeable team was involved in the RCA, this same group is well-equipped to answer these questions and reach a consensus on which root causes to target for intervention.
Prioritize Root Causes PowerPoint
The Prioritize Root Causes PowerPoint presentation provides a review of key terms and concepts necessary to understanding how to identify the root causes of a health inequity. It also illustrates how to use a priority matrix to choose the most important and most feasible root causes to address.
Design Care Delivery Transformation
The aim of an equity-focused care delivery transformation is to reduce and eliminate health inequities by enhancing how the healthcare system serves patients affected by these disparities. Collaborating with various organizations, particularly community-based ones, can significantly boost the success of your interventions by addressing the social determinants of health that contribute to inequities. These documents offer recommendations and outlines specific activities that organizations can undertake to create their own equity-focused care delivery transformations, ensuring a comprehensive approach to improving health outcomes for all patients. By leveraging diverse partnerships and targeted strategies, organizations can make meaningful progress toward a more equitable healthcare system.
Applying an Equity and Antiracist Lens to Quality Metrics and Data
Applying an Equity and Anti-racist Lens to Quality Metrics and Data is an abridged document focuses on standardization and its impact on racial and ethnic health inequities. The authors argue that a lack of standardized definitions for race and ethnicity, as well as concerns that focusing on those categories, might inadvertently reinforce the misconception that racial differences are biological. They maintain that the lack of standardization risks the occurrence of apathy or misdirected efforts that focus on the individual rather than systemic issues. Using several real-world examples, they make the case for using a racial equity lens and adopting anti-racist data practices.
PowerPoint Presentation: Design Care Delivery Transformation
Design Care Delivery Transformation is a PowerPoint presentation that walks audiences through how to:
⦁ identify potential care delivery transformations.
⦁ apply a root cause analysis and prioritization matrix.
⦁ pinpoint issues that might hinder the implementation of a care delivery transformation.
There is particular emphasis on the levels, strategies, and modes teams can use to design a care delivery transformation, as well as discussion questions that will help teams tie everything they’ve learned together.
Design Payment Transformation
Transforming complex coding, billing, and payment systems is often a gradual process involving many interconnected components. A change in one area can lead to unexpected adjustments in another, highlighting the need for a thorough review of each part of the process to ensure they work together toward a common goal. The relationship between payment structures and care interventions is crucial; how care is financed and how patients pay for services are key aspects of the transformation. While there is no one-size-fits-all solution, various strategies can help teams create an equity-focused payment structure that supports the overall care delivery transformation rather than hindering it. By considering these elements, organizations can work towards more effective and equitable healthcare solutions.
Discussion Guide: Design Payment Transformations
The Design Payment Transformation Discussion Guide acts as a complement to the Design Payment Transformation PowerPoint presentation. While each document can be used separately, AHE encourages using them in tandem. The discussion guide helps team pinpoint ways they can apply what they’ve learned from other sources and organizational teams about payment reform efforts and how to more fully engage community members in their efforts, among other topics.
PowerPoint Presentation: Design Payment Transformation
The Design Payment Transformation PowerPoint presentation acts as a complement to the Design Payment Transformation Discussion Guide. While each document can be used separately, AHE encourages using them in tandem. This presentation explains the basics of value-based payment, including general payment approaches and the roles of each stakeholder in the payment transformation process. By the end of the presentation, learners should be able to identify how Medicaid payers can use value-based payment to support care delivery transformations that promote health equity.
Implement Integrated Care Delivery and Payment Transformations
Equity is inherently linked to quality, so the most effective way to implement an equity transformation is by integrating it into ongoing quality improvement activities rather than treating it as a separate initiative. By adapting current quality improvement efforts to tackle the root causes of inequities in patient populations, organizations can minimize the need for launching entirely new projects. For instance, a quality improvement project aimed at enhancing hypertension control can be modified to also address disparities in process and outcome data. This approach leverages existing staff and resources while embedding equity into the organization’s culture, leading to more sustainable improvements in healthcare quality and equity.
Essential Elements
The Essential Elements component is critical to setting up multi-organizational teams for success in advancing health equity. By dedicating time to these core areas, teams create a strong groundwork that supports both immediate and long-term goals. This component ensures that teams are rooted in community engagement, mutual trust, and a shared vision, making their work responsive and relevant to those they serve. Additionally, addressing essential elements early on builds the necessary buy-in and cohesion across diverse stakeholders, creating a unified approach to tackling health inequities. By anticipating data needs, teams equip themselves to measure progress, make informed adjustments, and demonstrate impact effectively. In short, these elements embed accountability, inclusivity, and foresight into the health equity work, creating a resilient framework for collaborative, sustained action across all stages of the roadmap.
Partnering with Members and Communities
Patients and community members experience care differently than clinic staff and providers, giving them valuable insights into health equity issues. Their honest feedback can reveal the roots of inequities and suggest impactful solutions. Engaging their expertise is essential to creating effective models for transforming care and payment practices.
Practical Facilitation Guidance for Partnering with Members
Practical Facilitation Guidance for Partnering with Members offers guidance on ways to obtain first-hand input from individuals experiencing inequities. Receiving imput from indviduals with lived experience is essential to successfully reducing or eliminating inequities in health and healthcare.
The Spectrum of Community Engagement and Ownership
The Spectrum of Community Engagement to Ownership charts a pathway to strengthen and transform our local democracies. This tool was developed by Rosa González of Facilitating Power, in part drawing on content from a number of public participation tools, including Arnstein’s Ladder of Citizen Participation, and the Public Participation Spectrum created by the International Association for Public Participation. The contents have been piloted with municipal community-centered committees for racial equity and environmental justice at the cities of Portland Washington, Providence Rhode Island, Seattle Washington, and Washington DC; and with the Building Healthy Communities Initiative in Salinas, California, and developed in partnership with Movement Strategy Center.
Partnering with Inequities: Tips for In Person and Virtual Engagement
Tips for In Person and Virtual Engagement offers a variety of strategies for in-person or virtual meetings to connect with the individuals and communities at the heart of the work you do.
Value of Investing in Social Determinants of Health Toolkit
The Value of investing in Social Determinants of Health Toolkit is a resource from the Institute for Medicaid Innovation, an AHE partner. This toolkit represents Phase 1 of a multipart, turnkey suite of resources to allow Medicaid managed care organizations (MCOs) to articulate the business case for launching, leading, or expanding initiatives focused on inequities and social drivers of health.
With adaptable language, rationale, methods, and templates for their organizations, champions within Medicaid MCOs using this and future toolkits will have at their fingertips action-oriented tools to help move ideas forward.
Earning and Sustaining Stakeholder Buy-in
Securing buy-in is essential for launching and sustaining health equity initiatives. Success is more likely when all stakeholders—from organizational leadership to staff, patients, and community members—are committed to the work. The Roadmap emphasizes building an equity-focused culture, where everyone acknowledges inequities and shares responsibility for meaningful change.
Anticipate Data Needs and Opportunities
Anticipating data challenges from the outset of your initiative helps teams respond to unexpected issues. Similarly, involving the entire team in data collection and interpretation is vital. Front-line staff members who input data regularly can detect discrepancies that may be overlooked by others, preventing misinterpretations. Include these contributors in data analysis to improve accuracy and ensure alignment across partner organizations, especially if data collection systems differ.
Foundational Activities
In multi-organizational teams, foundational activities are essential for fostering effective collaboration toward health equity. Because these stakeholders often come from diverse backgrounds and may be meeting for the first time, establishing a foundation allows them to align on shared values, understand each other’s roles, and build trust. AHE’s Foundational Activities were created to encourage open dialogue, helping to uncover existing assumptions and preconceptions that could otherwise hinder teamwork.
They provide a structured approach to setting common goals, creating a shared language, and fostering an environment where all team voices are valued. By dedicating time to these foundational steps, teams are better equipped to navigate the complexities of health equity work, appreciate each partner’s unique contributions, and work more cohesively toward meaningful, sustainable change.
SOAR and Scenario Planning
Working through a SOAR analysis and Scenario Planning enables multi-organizational teams to identify strengths, envision shared aspirations, and explore potential future challenges and opportunities. The process fosters alignment, strategic focus, and resilience, equipping the team to collaboratively address health equity goals and adapt effectively to changing healthcare landscapes.
Team Charter
Creating a Team Charter helps multi-organizational teams establish clear roles, shared values, and mutual expectations. This foundational document promotes accountability, aligns team members on health equity goals, and fosters a respectful, collaborative environment. With a charter in place, the team is better positioned for coordinated, impactful action on health equity initiatives.