Start: November 2018

Funder: Robert Wood Johnson Foundation


There is growing consensus among national health care policy experts that aligning payment and quality improvement activities offers critical opportunities to improve health equity. Among Medicaid populations in particular, there are significant opportunities to use payment innovations to address health care disparities.

Advancing Health Equity: Leading Care, Payment, and Systems Transformation, a national program supported by the Robert Wood Johnson Foundation, is designed to identify and test effective ways to reduce and eliminate disparities in health and health care through a variety of approaches, including innovative Medicaid payment and contracting models. Under the initiative, the Center for Health Care Strategies (CHCS) is collaborating with the University of Chicago and the Institute for Medicaid Innovation to bring together key stakeholders — state Medicaid directors, Medicaid managed care organization (MCOs), and clinical partners — to pursue payment innovations that support health equity.

The program will seek to:

  • Determine effective ways to align payment and delivery system reform to achieve health equity and practical implementation lessons;
  • Increase the readiness of state Medicaid directors, MCOs, and provider organizations to successfully align payment and delivery system reforms to achieve health equity by creating and disseminating tools, resources, and training processes; and
  • Inform state and national level policy to improve health equity. 

Under a learning collaborative, the three partners will assist stakeholder teams in up to nine states in designing value-based payment and contracting models that support and incentivize health care delivery transformation to reduce and eliminate disparities in health and health care. Each team will consist of representatives from the state Medicaid agency, a Medicaid MCO operating in the state, and one or more provider organizations or systems contracted by the MCO. The collaborative activities will develop, test, and implement integrated payment and delivery system changes, as well as the challenges and barriers that prevent adoption.

In addition to the learning collaborative, Advancing Health Equity will provide tailored equity-focused technical assistance to state Medicaid agencies and coordinate a national advisory and policy development committee. The committee of national experts in health disparities, consumer and patient perspectives, state Medicaid programs, Medicaid MCOs, and providers will identify implementation lessons and develop policy recommendations for broad dissemination to other state Medicaid programs, health plans, providers, and policymakers.