Strengthening and Sustaining Primary Care

January 1, 2022

Dashni Sathasivam

Health Equity Solutions recently submitted a public comment on the Office of Health Strategy’s Roadmap for Strengthening and Sustaining Primary Care. This Roadmap is intended to inform the development of the state’s primary care infrastructure through health reforms that expand the team of providers caring for patients, align how they coordinate, and improve the system’s capacity to address social drivers of health by expanding payment options beyond a fee-for-service model.

Structural racism shapes social and economic inequities resulting in disparate health outcomes. HES recommends that the delivery of primary care and related processes and practices do the following to ensure equitable health care access, delivery, and outcomes:

Center equity as a criteria of payment models and measure progress towards equity.

  • Include an expanded health equity measure set
  • Require participants in alternative payment models to report on a standard set of CLAS metrics
  • Monitor data quality

Prioritize monitoring of risk-adjusted payments for adverse impact on people of color.

  • Actively monitor all risk-adjustment methodologies for bias
  • Test any algorithms used to allocate services or attribute patients to a practice for bias

Integrate community-based supports and organizations.

  • Clarify the definition of “embedded” non-clinical health workers to include lay workers across all settings and contractual arrangements to explicitly include more Community Health Workers
  • Incentivize and monitor community-clinical collaborations 

You can read HES’s full public comment here.