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What Should Antiracist Payment Reform Look Like?
Kimberly A Singletary1, Marshall H Chin2
1Diversity, equity, and inclusion and communication manager for the Advancing Health Equity: Leading Care, Payment, and Systems Transformation Program at the University of Chicago in Illinois.
AMA Journal of Ethics
|January 9, 2023
Summary
Racism in the US limits health insurance and quality care for people of color. Antiracist payment reforms can promote health equity and desegregate healthcare systems.
Area of Science:
- Health equity research
- Health policy analysis
- Social determinants of health
Background:
- Racism in the US restricts health insurance and high-quality care access for people of color.
- Current healthcare payment structures worsen racial segregation in care delivery.
- Inadequate payer and health plan support for minoritized communities' health needs.
Purpose of the Study:
- Outline foundational work for an antiracist culture of equity.
- Introduce the Roadmap to Advance Health Equity.
- Propose actionable antiracist payment reform strategies.
Main Methods:
- Review of existing literature on racism and healthcare disparities.
- Analysis of current payment structures and their impact on equity.
- Development of policy recommendations for antiracist payment reform.
Main Results:
- Identified need for increased health insurance coverage and scope.
- Proposed antiracism accountability within managed-care contracts.
- Advocated for support of the safety-net system and nonprofit hospital tax status.
Conclusions:
- Antiracist payment reforms can significantly reduce healthcare segregation.
- Reforms offer potential for equitable access to quality health services.
- Achieving health equity requires systemic payment structure transformation.
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