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Value-based payment (VBP) models shift health care payment from rewarding volume of care provided (i.e., fee-for-service payment) to rewarding the delivery of higher value care.1 As the health care system has increased its focus on health equity, many Medicaid payers, including state agencies and managed care organizations, see promise in aligning high-priority health care payment reform efforts with a focus on health equity. However, payers can’t succeed alone — reducing health inequities is complex and multifaceted, requiring a collective effort across the entire health care sector. Designing a successful, equity-focused VBP model involves a number of complex decisions, that should be informed by payers, providers, and the communities they serve.
This brief explores approaches to incorporating health equity in VBP design, creating payment models that positively impact health disparities, outcomes, and costs in Medicaid, including…