Prioritize Root Causes
What does it mean to prioritize root causes and why is it important?
Root cause analyses will reveal multiple underlying causes of a health inequity. Prioritizing the root causes for intervention is a critical next step because it is highly unlikely that any organization or collaborative can address all of them 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. When done collaboratively, prioritization also aligns stakeholders, secures leadership buy-in, and creates a realistic roadmap for implementation.
When should I prioritize root causes?
Prioritize root causes immediately after diagnosing them to keep your team focused on the most critical and actionable areas.
Consider re-prioritizing root causes in the future 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.
The chart below details the steps to take in prioritizing root causes as well as the approximate number of meetings for which to plan.
| Key Activities | Time Estimate: ~ 7+ Hours |
|---|---|
| Analyze the importance of addressing each of the root causes discovered in the root cause analysis | 1-3 one-hour meetings |
| Analyze the feasibility of addressing each of the root causes discovered in the root cause analysis | 1-3 one-hour meetings |
| Plot root causes on a priority matrix | 1 one-hour mtgmeetings |
| Select root causes to prioritize that are both very important and very feasible * In addition, consider selecting 1-2 root causes that are less important, but very feasible in order to achieve some “quick wins” for your health equity initiative. | 1-2 one-hour meetings |
| Present prioritized root causes to each stakeholder group for review and feedback. Adjust as necessary. | 3-5 one-hour meetings |
How should I prioritize root causes?
Use the Prioritize Root Causes presentation to guide your team in selecting which root causes to address. The presentation covers key equity and SDOH concepts, distinguishes between individual social needs and systemic drivers and explains why addressing them might not reduce inequities, and walks through a priority matrix to evaluate root causes by importance and feasibility.
Follow the guidance in the presentation and work as a team to create a priority matrix to help determine where to focus your care and payment model redesign efforts, while reinforcing community involvement and equity-centered decision-making. Taking the time to complete a priority matrix is always important, and even more so when resources are limited and teams must be strategic about where to invest and when stakeholders need alignment on what to address first.
Resources to Prioritize Root Causes
Prioritize Root Causes (Presentation)
Presents strategies for selecting which root causes of health inequities to address after completing a Root Cause Analysis, using a priority matrix to evaluate each cause by importance and feasibility. It also reviews key equity concepts essential for the task — including the distinction between SDOH and health equity — and emphasizes the importance of community involvement throughout the prioritization process.
Assessing Root Causes Prioritization
| Reprioritizing Root Causes |
|---|
| Instructions: Review and discuss the following prompts and use what is uncovered to identify next steps. The feasibility and importance of addressing specific root causes might change over time (e.g., shifting resources, new contract deliverables, revised requirements for internal or external quality improvement benchmarks). Consider the entire implementation timeframe for your initiative or the potential of extending it while discussing the following questions. * Can the team identify different root causes for immediate, mid-, and long-term attention? * Can the team now turn to working on root causes that were initially deemed lower priority? * Does the team have access to new or additional resources that can shift a root cause previously considered unfeasible to the feasible category? * Should the team create new or revised immediate, mid-, and long-term goals to address root causes based on care or payment intervention experiences to date, new contextual information (e.g,, an updated community needs assessment), or shifting resources or organization-level obligations? * Were any identified root causes tied to forms of oppression and/or discrimination? > Did the team flag those root causes for intervention? – If yes, where did those root causes land in the priority matrix? – If not, why not? |
| Improving Participation in Root Cause Prioritization |
|---|
| Instructions: Review and discuss the following prompts and use what is uncovered to identify next steps. Consider if any of the following key stakeholders were left out of the root cause prioritization process or had less influence than others. First, describe the level and manner of participation for each group. Second, identify ways that stakeholder groups with comparatively lower involvement could provide their feedback and expertise to review and provide feedback on the priority matrix. |
| Patients and Community Based Organizations * Patients living with the health equity focus * Representatives from community based organizations serving patients living with the health equity focus Healthcare Provider Organizations * Care team members serving patients living with the health equity focus; including but not limited to behavioral health specialists, care/case managers, community health workers, medical assistants, nurses/population health nurses, patient service representatives, call center staff pharmacists, and social workers. * Quality improvement specialists * Administrative staff; including finance, coding, and billing team members. Health Plans / Medicaid Managed Care Organizations * Population Health * Finance * Contracting * Health Equity and/or Social Drivers of Health * Underwriting/actuarial/compliance * Provider/Hospital Network Management * Senior Leadership (e.g., medical director) * Data analytics State/District Medicaid Agency * Value-based payment division * Data Analytics * Managed Care Contracting and Oversight * Quality Improvement * Population Health * Health Equity and/or Social Drivers of Health * Team focused on applicable health conditions or issues * 1115 waiver/SPA/other waiver teams * Senior Leaders (e.g., medical director) |
About the Roadmap Goal and Objective Setting Tool
This tool helps your team realize your vision to reduce and eliminate health and healthcare inequities by providing a centralized resource to:
- Establish process goals that align with each Roadmap component;
- Document task status, champions, and detailed notes;
- Monitor progress across multiple Roadmap components simultaneously; and
- Promote consistent team communication, accountability, and progress.
Use this tool to facilitate and document the development, implementation, and evaluation phases of your health equity initiative.