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The Center on Health Equity Action for System Transformation

Ensuring the Delivery and Payment Reform Tackles Inequities

As a nation, we need an efficient, high-quality, affordable health care system that works for everybody. Compared to other industrialized countries, we pay much more for health care and get much poorer results. But as bad as average health outcomes are in the United States, for some communities they are even worse, because of the enormous racial, ethnic, and other health and health care inequities that persist.

Efforts to improve the cost and quality of health care are ongoing and have centered on transforming our health care system from one that pays for volume to one that rewards value. However, very little attention has been paid to solving for equity, and as a result, health system transformation initiatives that have been implemented thus far have failed to significantly reduce health inequities. Given that we are but one generation away from a workforce that is majority people of color, this is a grave oversight that requires immediate attention.

The Risk and Opportunity of Payment and Delivery Reform

Payment and delivery reform efforts represent a critical crossroads for health equity.  On the one hand, health equity-centered payment and delivery reforms could focus on eliminating inequities proactively and supporting the care delivery models and interventions that accelerate disparity reduction. However, new payment systems that are designed and implemented without consideration of the impact on communities of color, complex patients, and other disadvantaged groups, could further undermine the health of communities that are already struggling.  Unfortunately, we are already seeing some of these negative unintended consequences. To turn this trend around, the voices of the leaders from the most affected communities must be inserted effectively into health system transformation efforts.

The Center on Health Equity Action for System Transformation is the only national entity exclusively dedicated to the development and advancement of patient-centered health system transformation policies designed to reduce racial, ethnic, and geographic inequities. We focus on advancing equity while improving outcomes, increasing value, and lowering costs. We catalyze and coordinate action to develop and implement health equity-focused health care delivery and payment policies.  We achieve impact by partnering with and supporting community leaders, health equity experts, and other stakeholders at national, state, and local levels.

The Center for Health Equity Action for System Transformation is made possible with the generous support of the W.K. Kellogg Foundation, the Robert Wood Johnson Foundation, the California Health Care Foundation, and the Patient-Centered Outcomes Research Institute.

Our Impact Strategy

  • Build and fuel a movement for equity-focused health care system transformation by galvanizing and coordinating action among diverse organizations and community leaders.
  • Channel and translate the power of the most innovative thinking from top thought leaders and policy experts into concrete, actionable strategies and recommendations for community leaders, stakeholders, and decision-makers to use.
  • Work with leaders who represent communities of color and other underserved groups to enhance their capacity to elevate the urgency of tackling inequities through health system reform and engage effectively in system transformation by providing critical strategic guidance, training, tools, and technical support.

Project Contact

For additional information, please contact Staci Lofton at