Disparities & Equity

The Institute for Medicaid Innovation (IMI), University of Chicago, and Center for Healthcare Strategies (CHCS) have partnered on an exciting three-year initiative, funded by the Robert Wood Johnson Foundation, "Advancing Health Equity:  Leading Care Payment & Systems Transformation."  The project is working to identify best practices, innovative initiatives, and policy recommendations for integrating payment and healthcare delivery reforms that seek to eliminate health and healthcare disparities and achieve equity by partnering Medicaid managed care organizations directly with state Medicaid agencies and healthcare provider organizations.

Project Components

The three-year project, beginning in 2019, consists of four key components, including:

1) National Advisory and Policy Development Committee that directs the work of the entire project and that includes a policy focused subcommittee tasked with developing specific policy and practice recommendations;

2) Learning Collaborative of seven teams comprised of a Medicaid managed care organization, the State Medicaid program in at least one market in which the health plans operates, and one or more healthcare provider organizations or systems contracted by the plan within that market;

3) State Medicaid Engagement and Technical Assistance Program, and

4) Rapid identification and dissemination of key findings. In consultation with members of IMI’s Data & Research (D & R) and Dissemination & Implementation (D & I) Committees, the 3-year initiative provides an opportunity for Medicaid health plans to be engaged in the national efforts of the project.

Learning Collaborative

The Learning Collaborative offers technical assistance and capacity building services to affiliated state Medicaid agencies, Medicaid managed care organizations, and health care delivery organizations to help them collectively design and implement integrated payment and health care delivery reform interventions to advance health equity while also engaging Medicaid enrollees, their families, and caregivers.

The seven teams attended a series of webinars in 2019 to assist them with selecting and developing their interventions. In 2020, the AHE Learning Collaborative is guiding each team through technical assistance to achieve their health equity goals through alignment of the teams' resources and strategies.  Emphasis is being placed upon engaging Medicaid members, sustaining the project, and designing and implementing payment reforms that support and incentivize equity-focused healthcare delivery redesign at the healthcare delivery organizations within the context of COVID-19.

The Learning Collaborative aims to discover best practice and policy recommendations for integrating payment and healthcare delivery reforms to advance health equity by eliminating health and healthcare disparities.

Project Teams

Through a competitive, national application process, seven teams comprised of state Medicaid agencies, Medicaid health plans, and health care delivery organizations in the states of Delaware, Illinois, Maine, New Jersey, Pennsylvania, Tennessee, and Washington, were chosen to participate in the Advancing Health Equity Learning Collaborative.

Delaware

Project Focus: Disparities in access to care for Black children.

Team Members:  Delaware Division of Medicaid and Medical Assistance, AmeriHealth Caritas Delaware, and Nemours/Alfred I. duPont Hospital for Children

Illinois

Project Focus: Health disparities related to housing.

Team Members:  HealthChoice Illinois, CountyCare Health Plan, Cook County Health, and Access Community Health Network

Maine

Project Focus: Disparities in behavioral health and substance-use disorder for formerly incarcerated individuals.

Team Members:  MaineCare, Community Care Partnership of Maine, Aroostook Mental Health Services, Inc., Pines Health Services, and The Maine Primary Care Association

Tennessee

Project Focus: Disparities in maternal mortality and morbidity and morbidity rates for postpartum Black womxn.

Team Members:  TennCare, UnitedHealthcare Community Plan of Tennessee, Tennessee Maternal Fetal Medicine, PLC, and Meharry College of Medicine

Washington

Project Focus: Disparities in access to prenatal and postpartum care for womxn of color.

Team Members:  Washington State Health Care Authority, Community Health Plan of Washington, and Community Health Network of Washington

Resources   

There are many resources that have been developed through the Advancing Health Equity project that are available for free to all Medicaid stakeholders.  Here are a few of our favorites.

Advancing Health Equity Through APMs: Guidance for Equity-Centered Design and Implementation

Creating a Culture of Equity

Roadmap to Reduce Disparities

Finding Answers: Disparities Research for Change

Improving Maternal Health Access, Coverage, and Outcomes in Medicaid

Essential Elements for a Maternal Health Intiative Business Case

Inequities Amplified By COVID-19: Opportunities For Medicaid To Address Health Disparities

Leveraging Value-Based Payment Approaches to Promote Health Equity

Using Data to Reduce Disparities and Improve Quality

Key Milestones: Designing Care Delivery Transformations to Advance Health Equity