Project: Developing a Framework to Introduce Equity of Access and Equity of Outcome to Reimbursement Approaches
William Roberts, MSc, Executive MBA (pending), is a 2025–26 U.K. Harkness Fellow in Health Care Policy and Practice. He is currently the chief operating officer of Walsall Healthcare NHS Trust, an integrated Hospital and Community Organisation providing care for 300,000 people in the second-most deprived of the NHS’s 42 Integrated Care Systems. Roberts started his career with the NHS Fast-track Graduate Management Programme. He completed his master’s degree in international health policy and health economics from the London School of Economics and Political Science and is also an alumnus of the International Hospital Federation’s Young Executive Leaders program. Roberts is completing his executive MBA from University College London’s Global Business School for Health. He has spent time working in the New Zealand health system for former Director General Stephen McKernan QSO. He maintains an active interest in both research and policy development, most recently looking at econometric models to support workforce planning and the use of predictive models for emergency visits to hospitals.
Project Overview: As value-based health care models gain traction in both the U.S. and the U.K., questions remain about how equity is accounted for in assessing system performance. While current definitions of value often focus on outcomes per unit cost, they rarely consider for whom that value is created. This project will develop a framework to measure equity as a core output of health care. The aim is to align service delivery and reimbursement models with goals to reduce disparities in access and outcomes. Using a Delphi consensus process with stakeholders from both countries, alongside a systematic literature review, the research will identify and test quantitative measures — such as the Kakwani Index — that reflect equity in access and outcomes. The framework will provide health care providers and policymakers with practical tools to evaluate and improve equity within service design, investment decisions, and incentive structures, supporting efforts to build more inclusive and efficient health systems.