Courtney Tyne and Michelle Nealy
Access to health care has increasingly been determined through some form of value assessment. However, frequently these assessments do not systematically or completely account for equity. In fact, conversations around value and equity have traditionally remained siloed, resulting in hardcoding of inequity in our current assessment models. Recently, Reservoir Communications Group convened a webinar with leaders in value assessment, health equity, and population health to discuss the question: can we have value without equity?
Our featured panelists included Cesar Herrera, Yuvo Health; Dennis Heaphy, Massachusetts Disability Policy Consortium; Marshall Chin, University of Chicago; and Orriel Richardson, Morgan Health. Their key point of agreement: we must intentionally place equity at the core of value assessment to design care systems and treatments that benefit diverse communities. Other key takeaways from the conversation included:
- Health care value and equity are interwoven.
Richardson noted that equity must be incorporated into how we assess value because if our “value benchmarks are based on deficient data or a deficient understanding, then we are baking that deficit into our understanding of optimal care.” Herrera provided a practical perspective, noting that upstream health care must be accounted for in developing new value-based arrangements, and that all stakeholders “need to understand the full system and community needs” to optimize health for all communities.
- Value should not solely be a monetary measure.
Heaphy stressed that value “must look at the social benefit not just the monetary benefit,” and that assessment measures like Quality Adjusted Life Years (QALYs) can discriminate against some communities and eventually harm society. Noting that “health care can play an important role in elevating the value of people,” he recommended stakeholders look at the long-term return on investment from a treatment or service (e.g., healthy workforce, equitable society), not just the short-term savings that may guide access decisions and further inequities.
- Community engagement is critical to incorporating equity into value.
When uniform care is the norm, Chin noted that equitable care requires us “to involve the community authentically because the community knows best what the drivers of health inequity are.” Intentionally gathering data about what is driving access barriers and how to structure systems to address these needs can calibrate future value-based frameworks rooted in health equity. “Interdisciplinary conversations and cross-sector partnerships” are critical too, said Richardson, so we don’t medicalize value but instead provide patient-centric care.
A full recording can be found here.
Additionally, if you would like to learn more about Reservoir’s offerings surrounding value and health equity, please reach out to Courtney Tyne (firstname.lastname@example.org) or Michelle Nealy (email@example.com) for more information.