Driver Diagram – DRAFT

More Equitable Health Outcomes

Intentionally designed APMs can help mitigate the negative impact that explicit and implicit biases and structural racism have on historically marginalized communities. By incentivizing and supporting care delivery changes that make care more equitable, APMs can drive better patient outcomes, reduce disparities, and advance health equity.


Change starts by incorporating APM design elements (secondary drivers)that are structured to incentivize and support equitable care delivery. If successfully implemented, these changes will result in people accessing culturally appropriate and integrated  care; providers delivering more  equitable and accessible care;  and payers, providers, and purchasers  identifyingopportunities for disparities reduction, setting specific and actionable health equity goals, and monitoring performance.

Payers and purchasers can voluntarily adopt promising design elements into APMs in an aligned manner to maximize provider uptake and the positive impact of APMs on health equity.
Providers participating in these APMs can make changes in care delivery that will enable them to advance health equity in a way that is flexible and aligned with fulfilling their mission
Individuals, families, their communities, and other relevant stakeholders can work with payers, purchasers, and providers to ensure changes in health care delivery and payment through APMs reflect their needs and preferences for change.


APMs leverage three inter-related features that are especially important for advancing health equity: Care Delivery Redesign, Payment Incentives and Structures, and Performance Measurement. These features:

  • Hold provider organizations accountable for delivering better care and achieving better health outcomes for all individuals;
  • Give providers greater flexibility to deliver whole-person care, consistent with each individual’s community, culture, and identity; and
  • Increase accessibility and use of effective, appropriate, and affordable care and services.
Care Delivery Redesign
lays out expectations within APM contracts for how care is delivered

Payment Incentives and Structures
that reward better care and outcomes

Performance Measurement
to capture performance and drive accountability


Alignment across payers for select design elements promotes APM adoption among providers, ultimately bolstering positive impacts on communities experiencing health inequities.