Health Equity Strategies from the AHC Model

Drawing from the experiences of awardees participating in the CMS Accountable Health Communities (AHC) Model, this tip sheet provides a multi-level framework for understanding health equity and actionable strategies related to social needs interventions that organizations such as health systems, payers, and community service providers can leverage to improve health equity.


Advancing health equity is critical to optimizing population health and improving the quality of healthcare while potentially reducing costs. A comprehensive approach to addressing health equity both improves health outcomes through enhanced access to community resources and seeks to address the underlying structural drivers of health. Without a focus on equity within health-related social needs interventions, underlying inequities can persist.


The strategies highlighted in this tip sheet are organized by individual, community, and societal health to help organizations understand how they can advance health equity at each level and develop a comprehensive health equity strategy.


Read the Tip Sheet


This resource was prepared on behalf of the Centers for Medicare & Medicaid Services by Rishi Manchanda, Sadena Thevarajah, Sara Bader, Alexis Taylor, and Roza Do of HealthBegins as well as Mario Gruszczynski, Kelsey Cowen, and Risa Nakajima of Mathematica under the AHC Model Implementation, Learning System, Technical Assistance, and Monitoring contract.

Featured Content

Staff Spotlight: Erica Jones, Following Her Path and Passion to Help People

“I wish people would try to advocate for themselves more, because I feel like there's this power struggle and people don't feel like they can.”

Staff Spotlight: Kyron Pierce, The Eagle Scout with a Passion For Helping People Lead Healthy Lives

“[Health equity] is very hard work and it might be some years for us to see the fruits of our labor, but it'll be worth it when you do produce it.”

Staff Spotlight: Alejandra Cabrera, Perfectly Imperfect Artist and Health Equity Advocate

When I work with people and communities, I always think back to this sense of not belonging and it drives me to continue to do the heart-work we need to do to advance health equity.