Aligning Payment and Policies With Health Care Value and Equity

Abstract

The US health care system often fails to deliver value (ie, outcomes relative to spending) or equity (ie, ensuring fairness in process or outcomes by race, ethnicity, social class, etc). A central question confronting the Biden-Harris administration is: Which policy and payment reforms will improve health care value and equity? In this Viewpoint, we propose starting with hypertension control and blood pressure (BP) equity as a national vital sign for unifying policy and payment reforms to accomplish these aims. Health Care Value and Equity Requires Improving National Vital SignsNational vital signs are core, modifiable factors that profoundly influence population health and health care spending, and monitoring national vital signs can reduce health disparities. 1,2 Notable examples include BP, obesity, physical activity, smoking, patient engagement/self-management, and well-being. 1 Addressing health care value and equity requires aligning policies and payment to improve national vital signs.Blood pressure control represents a natural starting point because it is a widely used clinical measure. It is the single most important risk factor for cardiovascular disease and a critical determinant of racial disparities in cardiovascular disease. 3 National BP control rates have regressed in recent years, 4 signaling the need for coordinated, integrated action.Open Access. This is an open access article distributed under the terms of the CC-BY License.

Advancing healthcare equity through dissemination and implementation science

“…Additionally, low levels of knowledge about health inequities and limited beliefs about their existence 217,218 can affect provider care 123 and policies that foster equitable solutions 214 . Dissemination research can advance understanding of how to reach and promote best practices that increase uptake of evidence‐based information by practitioners and policy makers and inform policy actions (e.g., payment reforms that will improve healthcare value and equity) 128,131,216,219,220 . Table 2 provides additional examples of actions that can be taken to foster healthcare policy making.…”

“… 214 Dissemination research can advance understanding of how to reach and promote best practices that increase uptake of evidence‐based information by practitioners and policy makers and inform policy actions (e.g., payment reforms that will improve healthcare value and equity). 128 , 131 , 216 , 219 , 220 Table 2 provides additional examples of actions that can be taken to foster healthcare policy making.…”