Creating the Business Case for Achieving Health Equity

Area of Science:

• Health Services Research
• Health Policy
• Health Equity Studies

Background:

• Health care disparities persist across racial/ethnic and socioeconomic groups.
• Health equity is not yet a priority for many health care organizations.
• Financial incentives are a significant barrier to achieving health equity.

Purpose of the Study:

• To outline strategies for creating a business case for health equity.
• To identify mechanisms for governmental and private payors to incentivize health equity.
• To address financial barriers hindering the reduction of health disparities.

Main Methods:

• Recommending mandatory reporting of clinical performance data stratified by race, ethnicity, and socioeconomic status.
• Proposing financial incentives for preventive and primary care, including shared savings plans and updated fee schedules.
• Suggesting equity accountability measures in payment programs and alignment across payors.
• Advocating for support of safety-net organizations and risk adjustment for sociodemographic factors.
• Recommending demonstration projects for payment and delivery system reforms.

Main Results:

• Establishing a business case requires financial feasibility for interventions.
• Incentivizing preventive care and reducing disparities can be achieved through specific payment reforms.
• Support for safety-net organizations and risk adjustment are key components of an equitable system.
• Alignment of accountability measures across payors is essential for widespread impact.

Conclusions:

• Achieving health equity requires both a commitment to social justice and a robust financial framework.
• Payment and delivery system reforms are critical for making health equity interventions financially feasible.
• Payers have a pivotal role in incentivizing and mandating actions that reduce health care disparities.