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Implement the Care Delivery and Payment Transformation

What is this and why does it matter?

Implementing care delivery and payment transformations marks the critical phase where your team puts plans into action. Even with a strong equity culture, a clear health equity focus, and well-designed interventions, you should expect to face unexpected challenges during implementation.

To succeed, execute strategically, stay adaptable, and commit to continuous learning. Don’t treat health equity as a standalone effort—integrate it into your existing quality improvement work to keep equity at the core of healthcare transformation.

When you implement changes in a structured, measurable, and scalable way, you create sustainable impact and improve health outcomes for historically marginalized populations.

How should you work through this component?

To implement equity-focused changes effectively, start small, learn quickly, and adapt continuously. Use tools like the PDSA cycle and pilot testing to spot challenges early and refine your approach before scaling. Track process measures to demonstrate early progress, and stay flexible while remaining grounded in your core equity goals.

As your work evolves, focus on measuring equity gaps—not just overall improvement—to ensure that care truly improves for those most affected by disparities.

When does it make sense to work through this component?

Implementation should begin once care delivery and payment transformations have been designed and tested. It is most critical when:

If organizations wait too long to implement, momentum can be lost. Taking action and iterating along the way ensures continuous progress.

Curriculum to be completed for this component:

Implementing the Integrated Care Delivery and Payment Transformations (Base Deck Presentation)

The Implementing the Integrated Care Delivery and Payment Transformations presentation guides teams through putting their equity-focused care and payment redesign into action, covering four key implementation strategies — transformation fit, organizational prerequisites, stakeholder adoption, and internal communication — alongside essential elements such as community partnership, stakeholder buy-in, and data readiness.

It also introduces practical frameworks for pilot testing, measurement, and evaluation, using real-world case studies from Washington, Delaware, and Mississippi to illustrate how teams can start small, track progress, and scale their efforts over time.

RIC – Implemention – Base Deck Presentation 06.2025Download

Self-Assessment Topics and Questions:

This self-assessment tool will help you identify, anticipate and address common challenges implementing the Roadmap.  Using it will increase your chances of successfully reducing and eliminating health and healthcare inequities. Each Roadmap component will have a set of questions and topics in their respective sections; AHE recommends utilizing the assessment questions in two ways:

  1. Are the care and payment models being rolled out simultaneously or sequentially?
  2. Will the initiative “start small” by using a pilot (highly recommended)?
  3. Is there a plan for PDSA-type cycles?
  4. Is the team operating with an iterative design/approach and the need for implementation flexibility?

Goal and Objective Setting:

About the Roadmap Goal and Objective Setting Tool

This tool is designed to facilitate goal setting and completion for your team. The tool will allow your team to:

  1. Record goals which align with the various Roadmap components
  2. Record objectives, time frames, and target completion dates, among other important items for each goal
  3. Monitor progress of goals per Roadmap component

Your team is welcome to engage with this tool as much or as little as it would like, and is helpful, in the development, implementation, and evaluation of your health equity initiative. We encourage you to use this tool to ensure clear goal setting and promote consistent communication, accountability, and progress within your team. This tool is designed to be used over time as your team progresses through the Roadmap and your initiative. This is in no way intended to be used one way by all teams. This is meant to help you progress through the Roadmap component(s) on which you are working at a given time and you may reach your goals in any order. We welcome you to consult your AHE TA lead on getting started with this tool.

Each Roadmap component is listed as a separate tab. Navigate to the desired Roadmap component via the task bar at the bottom of the webpage to add, edit, or view goals. Hide certain tabs as needed to narrow your view to specific Roadmap components or the snapshot. Changing the status of a goal will automatically shift the Snapshot view for the specific Roadmap component.