15 Aug Payer Strategies for Advancing Health Equity Through Value-Based Payment
Advancing health equity is a critical element of health care quality that directly ties to improved patient experiences and outcomes. Efforts to promote health equity reflect a moral imperative and can reduce health care costs through effective care management, which in turn helps decrease avoidable hospitalizations, emergency department visits, and low or no-value care. Health care payers play a vital role in this effort by designing and implementing value-based care models and payment arrangements that enhance high-quality, coordinated patient care.
In this resource, the Task Force presents case studies that describe efforts by payers to:
- Develop infrastructure through up-front grant funding: Payers can enable providers and partners to develop the infrastructure necessary to implement programs to address health disparities for historically underserved populations through up-front grant funding.
- Utilize social risk adjustment methodologies: Payers can utilize social risk adjustment methodologies to account for high-risk patients and provide more funding to clinicians and providers serving these patients.
- Collaborate with community-based organizations (CBOs): Leveraging CBOs allows payers to tap into community assets, partner to address health related social needs (HSRNs), and implement culturally competent care, all of which can advance health equity.
- Facilitate low-income provider participation: Payers can support low-income providers in value-based transformation efforts by helping them to navigate and counteract financial constraints, a lack of data and analytics capabilities, limited population health management capacity, and complex reporting requirements.