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Prioritize Root Causes

What is this and why does it matter?

After completing a Root Cause Analysis, your team will likely identify multiple underlying causes of a health inequity — and prioritizing them is a critical next step. Since you can’t address everything at once, focusing on the most impactful and feasible causes keeps your efforts strategic and sustainable.

Prioritization helps your team maximize impact by targeting the most significant drivers of inequity, use resources efficiently by weighing feasibility and readiness, and build momentum through quick wins while advancing long-term structural change. This process also aligns stakeholders, secures leadership buy-in, and creates a realistic roadmap for implementation.

How should you work through this component?

Use the Prioritize Root Causes presentation to guide your team in selecting which root causes to address after completing your Root Cause Analysis. It covers key equity and SDOH concepts, distinguishes between individual social needs and systemic drivers, and walks through a priority matrix to evaluate root causes by importance and feasibility.

This tool helps your team determine where to focus your care and payment model redesign efforts, while reinforcing community involvement and equity-centered decision-making.

When does it make sense to work through this component?

Prioritization should occur immediately after diagnosing root causes to keep your team focused on the most critical and actionable areas. It is especially important when resources are limited and teams must be strategic about where to invest, when stakeholders need alignment on what to address first, when competing priorities risk stalling health equity initiatives, or when new opportunities — such as policy changes or funding availability — make previously low-feasibility causes more attainable.

Curriculum to be completed for this component:

Prioritize Root Causes (Base Deck Presentation)

The Prioritize Root Causes presentation guides teams through selecting which root causes of health inequities to tackle after completing a Root Cause Analysis, using a priority matrix to evaluate each cause by importance and feasibility. It also reviews key equity concepts — including the distinction between SDOH and health equity — and emphasizes the importance of community involvement throughout the prioritization process.

RIC – PRC – Base Deck PPT – 6.2025Download

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:

It is typical to find numerous root causes for health and healthcare inequities.  The prioritization process helps teams identify which root causes to address immediately and which root causes to address in the future; for example, when more resources are available, when the prioritized root causes have been addressed, or after the team has gained more experience.  Your team should contemplate the following questions every three to six months.

  1. Did the team identify different root causes for immediate, mid-, and long-term attention?  If so, revisit the root causes on a regular basis and consider the following:
    • Can the team work on root causes that were initially deemed a lower priority?
    • Should the team create new or revised immediate, mid-, and long-term goals for addressing the root causes based on its experiences thus far or new information?
  1. Were any of the following key stakeholders left out of the root cause prioritization process or had less influence over the process compared to others?

Consider involving the groups who were left out (or who had less participation than others) in the reprioritization process or increasing their involvement.  Begin by summarizing the level of participation they had in previous deliberations regarding the prioritization of root causes.  Finish by determining how they can be involved in the reprioritization process.  See the Earning and Maintaining Stakeholder Buy-in and Partnering with Members and Communities components of the Roadmap for helpful information.

Key stakeholders at healthcare provider organizations

  1. Patients living with the health equity focus
  2. Representatives from community-based organizations who serve patients living with the health equity focus
  3. Care team members serving patients living with the health equity focus
    • Patient service representatives
    • Pharmacists
    • Community health workers (CHWs)
    • Social workers
    • Behavioral health specialists
    • Medical assistants
    • Nurses
      • Population health nurses
    • Care/case managers
  4. Quality Improvement team members
  5. Call center team members
  6. Finance team members
    • Coding and billing team members

Describe their level and manner of participation.

Key stakeholders at state Medicaid agencies:

  1. Value based payment division
  2. Data analytics
  3. Managed care contracting/oversight
  4. 1115 waiver/SPA/other waiver teams
  5. Teams focused on specific health conditions or issues (e.g., primary care, long-term services and supports, maternal health)
  6. Senior leadership
  7. Medical Director and clinical team
  8. Quality improvement (QI)
  9. Health equity and/or SDOH team (may sit within a population health or QI team)
  10. Community outreach/engagement team

Describe their level and manner of participation.

Describe their level and manner of participation.

Continue to contemplate factors that make key root causes difficult to address.  Has anything changed in the current environment that makes it easier to address those factors now (or in the near future)?  Examples include new sources of funding, new leadership or community representatives that are motivated to address the factors.

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.