Catalyst for Payment Reform

A Peek at CPR’s Equity Journey

A Peek at CPR’s Equity Journey

As 2020 came to an end and the call to address equity in all facets of society, health care included, was at a ground swell, the Robert Wood Johnson Foundation (RWJF) responded by offering its grantees the opportunity to participate in what they coined an Equity Learning Lab (ELL). The overarching goal of the ELL is to accelerate the uptake of practices, processes, and policies that advance equity, diversity, and inclusion within both internal organizational functioning and external mission-focused work. CPR welcomed the opportunity to participate and two years later we are 22 months into our ELL journey and grateful to RWJF for affording us this opportunity. 

Participating in the ELL has been an incredibly valuable experience. The ELL has provided tools to assess and set organizational goals, online curriculums to learn about principles of equity, virtual group gatherings to share resources and experiences and collaborate, access to subject matter experts, and a personal coach to support our work. Through our engagement with the ELL, CPR and other participating organizations completed a comprehensive organizational assessment to identify opportunities to further advance equity both within CPR and through our projects. We assessed our:

  • Mission and vision 
  • Culture and values
  • Leadership and decision-making structures
  • Organizational strategy
  • Programs and initiatives
  • Communications and messaging 
  • Internal evaluation and learning mechanisms
  • HR and talent management
  • Finance and operations 

As a result of this review, we have since focused our efforts on ensuring equity is considered in our HR and hiring policies, reassessed our mission and vision and drafted new statements anchored in equity, considered asset-framing and positive messaging in our communication strategies, and held general, open all-staff discussions on topics of equity relating to our professional and personal lives.

However, we are most excited about the opportunity to advance principles of health equity through our programs and initiatives. As an organization that provides practical and actionable tools and resources to employer-purchasers providing health benefits to their employees, there are many tangible steps we are taking. We are ensuring the creation of equitable benefit designs and health care initiatives focused on equitable care access, delivery, and outcomes, as well as creating educational resources on equity for purchasers. For instance, with the help of our ELL coach, CPR updated its flagship resource – the Aligned Sourcing & Contracting toolkit – to include areas of opportunity for employer-purchasers to push for health equity.  As the toolkit includes editable documents purchasers can use to set health plan expectations during the health plan selection, renewal, and contracting phases, those fielding these resources can send a consistent signal to the market that equity matters. CPR is also looking to update its formal evaluation tools, the Reform Evaluation Frameworks (or REFs), in a similar manner. 

Other work inspired by the ELL includes educational efforts to help purchasers infuse equity into their benefit design offerings, as well as embarking on a comprehensive redesign of the Purchaser Toolkit for Serious Illness Care Strategies to ensure this resource – covering care management, pain management, ACOs, caregivers, network design, and more – addresses issues of disparities in palliative care.

In closing, one of the more eye-opening takeaways from participating in the ELL is the realization that organizations of any size and type can take action on equity; there are strategies for all. A large organization that hires 100s or 1000s of employees annually may have a significant impact by ensuring their hiring practices are equitable which can lead to a more diverse and inclusive organizational culture. A small organization like CPR may have the greatest impact by embedding the lens of equity in the content produced and widely shared, while a data driven organization may commit to a transparent use of data to examine equity outcomes.  The work might not look the same at all organizations, however there is always a place to start.

Equity work is not necessarily easy, however the experience here at CPR has been a rewarding one. 

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