Historically, payment structures focused on keeping systems functioning smoothly, without addressing ways to serve marginalized populations and alleviate inequities. While there is no one-size-fits all approach, strategies can be adopted to develop equity-focused payment structures to support care delivery transformation including:

• Assessing Stakeholder Needs
  While assessing financial priorities, consider how data will be used to identify health disparities, who the stakeholders are, and how a culture of equity can be created.
• Determining Costs
  Consider necessary upfront investments and if they will result in future decreased costs.
• Deciding Measurements and Targets
  Be clear about which performance measures will illustrate achievement, how to chart improvement, and which success benchmarks to use.
• Deciding on Payment Model
  Consider how well the model supports goals, including pros and cons. Ask if it links to outcome measures/targets.
• Planning Incentives and Flexibility
  Determine how incentives will improve quality, if they encourage long-term changes, and use data to make changes.