P4P Health Equity
Task Force

The P4P Health Equity Task Force supports the development of pay-for-performance (P4P) incentives designed to address and rectify disparities in health care outcomes across Michigan. The Task Force is a diverse coalition of key stakeholders, including content experts, representatives from collaborative quality initiatives (CQIs), community organizations, hospitals, and Blue Cross Blue Shield of Michigan (BCBSM), with the shared objective of championing health equity through quality incentives.

By creating an aligned and consistent process for health equity focused initiatives in hospitals and CQIs, our goal is to advance health care equity and contribute to improved health for all people in Michigan.

In recent years, there has been a significant and commendable shift in the priorities of national health care policymaking organizations, including the National Committee for Quality Assurance (NCQA), the Centers for Medicare & Medicaid Services (CMS), and the Joint Commission, towards the incorporation of health equity-related quality measures. This shift is a direct response to the growing recognition of persistent inequities in health care access, quality, and outcomes that exist in Michigan and the U.S. These organizations acknowledged that measuring and addressing health equity is essential for achieving health care quality.

CQIs address many of the most common and costly areas of surgical and medical care in Michigan. In each CQI, hospitals and physicians across the state collect, share, and analyze data on patient risk factors, processes of care and outcomes of care, then design and implement changes to improve patient care. The CQI infrastructure enables granular data collection from a wide variety of clinical sites, and the analysis of additional data sources, while fostering deep collaboration among hundreds of health care partners to share best practices for improving care and patient outcomes.

To concurrently advance the promotion of health equity and ensure Michigan hospitals and CQIs meet national quality benchmarks, the Health Equity Task Force has developed a framework and guidance for equity focused measures in BCBSM’s P4P program. The Task Force has initially proposed recommendations in 3 areas, including race/ethnicity data collection and coding, social needs screening and linkage, and building capacity and a culture of health equity in quality improvement. For each of these, we discuss the proposed recommendations in more detail and our rationale for selecting these recommendations. We also present plans for next steps in future years that can build upon this initial set of recommendations.

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