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 (AHE), 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. Through AHE, 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:

  • 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 an AHE learning collaborative launching in October 2019, the three partners are assisting stakeholder teams in seven 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 consists 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. Participating teams include:

  • Delaware – Delaware Division of Medicaid and Medical Assistance; AmeriHealth Caritas Delaware; and Nemours/Alfred I. duPont Hospital for Children
  • Illinois – HealthChoice Illinois; CountyCare Health Plan; Cook County Health; and Access Community Health Network
  • Maine – MaineCare; Community Care Partnership of Maine; Aroostook Mental Health Services; Pines Health Services; and The Maine Primary Care Association
  • New Jersey – New Jersey Department of Human Services, Division of Medical Assistance and Health Services; Horizon Blue Cross Blue Shield of New Jersey; and RWJ Barnabas Health, Newark Beth Israel Medical Center and Jersey City Medical Center
  • Pennsylvania – Pennsylvania Office of Medical Assistance Programs; Gateway Health Plan; Allegheny Health Network; and North Side Christian Health Center
  • Tennessee – TennCare; UnitedHealthcare Community Plan of Tennessee; Tennessee Maternal Fetal Medicine; and Meharry College of Medicine
  • Washington State – Washington State Health Care Authority; Community Health Plan of Washington; and Community Health Network of Washington

In addition to the learning collaborative, AHE 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.