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. 2023 Jan 1;25(1):E55-65.
doi: 10.1001/amajethics.2023.55.

What Should Antiracist Payment Reform Look Like?

Kimberly A Singletary  1 , Marshall H Chin  2
Affiliations

What Should Antiracist Payment Reform Look Like?

Kimberly A Singletary et al. AMA J Ethics. .

Abstract

Racism reduces eligibility for health insurance and access to high-quality care for people of color in the United States, and current payment structures exacerbate the resultant de facto racial segregation. Payers and health plans do not adequately support and incentivize clinicians and health care delivery organizations to meet the health needs of minoritized communities. This article describes foundational work needed to create an antiracist culture of equity; the Roadmap to Advance Health Equity; and specific, actionable antiracist payment reform strategies, including increasing access to and the scope of health insurance coverage, antiracism accountability in managed-care contracts, support for the safety-net system, strengthened nonprofit hospital tax status requirements, and payment incentives to advance health equity. Antiracist payment reforms have great potential to desegregate health care systems and to ensure that everyone has a fair opportunity to receive good health services and optimize their health.

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Conflict of interest statement

Conflict of Interest Disclosure

Dr Chin is a lead subject matter expert on health equity research for the Agency for Healthcare Research and Quality, co-chairs the Centers for Medicare and Medicaid Services Health Care Payment Learning and Action Network Health Equity Advisory Team, and is a member of the National Institute of Diabetes and Digestive and Kidney Diseases’ Health Disparities and Health Equity Working Group. He is also a member of the Bristol Myers Squibb Company Health Equity Advisory Board and the Blue Cross Blue Shield Health Equity Advisory Panel. Dr Chin previously was a consultant on health equity to the Patient-Centered Outcomes Research Institute and a member of the National Institute on Minority Health and Health Disparities National Advisory Council. Dr Singletary had no conflicts of interest to disclose.

Figures

Figure 1.
Figure 1.
Create an Antiracist Culture of Equity
Figure 2.
Figure 2.
How to Implement the Roadmap to Advance Health Equity
See this image and copyright information in PMC

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