The Commonwealth Fund’s Advancing Health Equity program, established in 2021, aims to advance equity in U.S. health care. Its goal is to eliminate unequal treatment, experience, and outcomes in health and health care for people of color by reducing systemic racism in health care policy and practice through three focus areas: promoting antiracism in health care delivery systems, promoting antiracism in health care policy, and changing the mindset of health care leaders and professionals.
Promoting antiracism in health care delivery systems
Financial and regulatory pressures can motivate health care leaders to examine their internal cultures, attitudes, and beliefs and take remedial action. Delivery systems have opportunities to examine their practices, better understand the needs and experiences of the people they serve, and implement antiracist interventions to advance health equity in their communities. The Advancing Health Equity program will develop, promote, and evaluate interventions to:
- Disseminate effective antiracism practices within health systems or models of community partnership, both in the United States and abroad
- Incentivize progress toward antiracism goals through pay-for-value programs
- Promote the collection and reporting of data disaggregated by race and ethnicity
- Create accreditation standards for measuring, tracking, and reporting on comparative care experiences
- Establish regulatory requirements for inclusive community partnerships.
Promoting antiracism in health care policy
Having health insurance alone is not a guarantee of receiving equitable health care services. The Advancing Health Equity program will fund efforts to ensure federal and state policies related to health coverage explicitly combat racism and ensure satisfactory access to high-quality services from community providers that prioritize equity. Examples of activities include:
- Evaluating how options for expanding coverage through the Affordable Care Act would combat systemic racism and improve the health and well-being of people of color
- Examining how Medicare, Medicaid, and other coverage programs can dismantle racism in health care and better serve people of color
- Developing new policy options that can address inequities in care.
Changing the mindset (attitudes, culture, values, beliefs) of health care leaders and professionals
People who work in health care are too often unaware of, or ignore, the ways in which prevailing institutional culture and personal attitudes contribute to racism. To foster antiracism in health care, it will be essential to show how racism and bias manifest themselves within management, among members of the workforce, and between patients and providers. Examples of work in this area include:
- Shaping views, attitudes, and beliefs concerning prevalence of racism in health care
- Understanding how the effects of discrimination manifest in unequal treatment, outcomes, and experiences in health care
- Documenting reports of health systems’ involvement and role in antiracism activities in their personal or professional lives.
Laurie Zephyrin, Vice President
2022 Program Funding Priorities
Understanding, changing, and shaping narratives as they relate to racism manifesting in the health care system and different ways systems are working to dismantle structural racism
Testing and implementation of new delivery models and/or modification of existing delivery models incorporating health equity-related metrics
Understanding how health care payers are developing reimbursement models that reward closing health disparities
Identifying effective Medicaid policies that advance health equity, particularly in maternal health
Conducting analysis of federal and state policies (and identification of policies) to understand how they impact health equity