States are increasingly focusing on health equity, and in particular racial health equity, as a key priority within their Medicaid programs ― often explicitly building health equity requirements into managed care contracts. Ensuring equitable access to high-quality and comprehensive primary care is central to achieving meaningful progress toward this goal. As a result of structural and interpersonal racism, people of color are more likely than white individuals to face barriers to primary care access, including reporting discrimination within the health system. One opportunity for states to advance more equitable primary care is to set standards for primary care practices by building on a common framework: the patient-centered medical home (PCMH).
PCMH is a care delivery model aimed at providing patient-centered, accessible, coordinated, and comprehensive primary care with a commitment to quality improvement. The fact that state PCMH programs are both widespread and focused on patient needs and preferences, make these programs a strong starting point for developing capabilities to support health equity at the practice level. Moreover, practice-level standards can be complementary to managed care contracting requirements, helping to align efforts to advance equity across the health system.