The Commonwealth Fund’s Health Equity Action Fund is a major new initiative to advance equity in U.S. health care. Its goal is to contribute to efforts to dismantle systemic racism in health care policy and practice and counter inequity in treatment, patient experience, and health outcomes for Black people, Indigenous people, and people of color.
Dismantling Racism in Care Delivery
Financial and regulatory pressures can motivate health care leaders to examine their internal cultures, attitudes, and beliefs and take remedial action. At the same time, delivery systems must partner with their local communities in order to fully understand the needs and experiences of the people they serve and to become effective antiracist organizations. The Health Equity Action Fund will develop, promote, and evaluate interventions to:
- Disseminate effective antiracism practices or models of community partnership, both in the U.S. 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.
Changing Culture, Beliefs, and Attitudes
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 manifests itself within management, among members of the workforce, and between patients and providers. Examples of work in this area include:
- Efforts to track the history of racism in U.S. health care and health policy and the impact of racism and bias on health outcomes and patient experience
- The development of metrics for assessing how racism manifests itself in health care
- The application of equity measurement and reporting systems for tracking progress in dismantling racism in health care.
Using Policy to Bring About Equitable Access
Having insurance does not alone guarantee equity in the provision and receipt of health services. The Health Equity Action Fund will sponsor efforts to ensure federal and state policies related to health coverage explicitly combat racism and ensure good 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.
Laurie Zephyrin, Vice President