Our definition of health equity, in alignment with public health experts, is both deceptively simple and incredibly complex: the idea that everyone should have fair and just opportunities to achieve the best health possible, regardless of any socioeconomic factors that may influence their ability to access these opportunities (e.g., gender, race, geography, education, and income, among others). This guiding principle has informed much of our work over the past four years and remains a priority for our organization.  

We also recognize that achieving health equity is a complex, ongoing process that requires collective effort across multiple stakeholder groups. Here, we reflect on our progress toward reducing disparities in our local communities – including the specific areas where our organizational focus on health equity has allowed us to improve care delivery for historically underserved groups. We hope these learnings can inform the broader industry dialogue around health equity and ultimately create a more equitable system of care for patients receiving Medicaid. 

Equity in Technology and Our Clinical Model

Numerous studies have demonstrated the effectiveness of multidisciplinary, community-based care teams in improving health and social outcomes for disadvantaged groups receiving Medicaid. These teams can bridge a significant gap between traditional primary care practices and patients whose health is largely influenced by factors beyond the clinic walls.

However, despite their potential, community-based care teams often face challenges stemming from a lack of purpose-built technology to support their work. Moreover, they lack access to the technical teams needed to design software that can scale their programs across diverse communities, healthcare settings, and existing healthcare data platforms. As a result of both these factors, care teams are often burdened with excessive manual labor that contributes to burnout. 

To address this challenge, we’ve invested in participatory software design to ensure our technology reflects the needs of our community-based workforce and the patients they serve. Lighthouse – our flagship patient relationship management product – is one such example. When our teams set out to design a solution for our remote, community-based teams, we knew that we needed to prioritize building something new from the ground up instead of spending time and energy attempting to leverage an out-of-the-box solution built for other (likely more affluent) populations. In a similar vein, Waymark Signal™, our proprietary machine-learning technology, was specifically designed to predict avoidable hospitalization and emergency department (ED) visits while also reducing the racial and ethnic bias present in traditional risk prediction models. 

We also understand that contributing to the broader evidence base around health equity through peer-reviewed studies can enable others to learn from and implement more equitable care delivery models. That’s why we prioritize testing and validating our work through rigorous and peer-reviewed studies evaluating our technology and care model. Every time we submit a paper for peer review, we’re re-committing ourselves to advancing the existing evidence base around health equity and holding ourselves accountable to the rigorous scientific research standards that ensure we make a real and lasting impact in our communities.

–Sanjay Basu, Co-Founder and Head of Clinical 

Equity in Partnerships

Internally and externally, we prioritize entering markets and partnerships where patient outcomes are historically suboptimal – and we do this intentionally, as that indicates broader inequities Waymark can help address. When we meet with health plans and primary care providers in these markets, we enter those discussions with a service mindset. What unique challenges are these communities facing? How is Waymark positioned to address those challenges? These questions are our north star as we approach these conversations.

We realized early on that actually improving health equity in our communities would require rethinking how we pay for clinical and social interventions for underserved communities. We observed that many value-based payment programs in Medicaid are actually “value veneers,” or modest pay-for-performance programs, performance bonuses, or shared savings arrangements that technically qualify as value-based care, but don’t actually incentivize meaningful changes in care delivery. In fact, since patients can only be assigned to one value-based care agreement at a time, we’ve found that these agreements may actually impede true value-based care programs designed to address health inequities. We’re grateful to many of our forward-thinking health plan and provider partners for exploring alternative payment models to ensure true value-based care delivery for their populations. 

Ultimately, our definition of a successful partnership is one that moves health equity forward. For patients from traditionally underserved communities, this can take several forms: reducing avoidable hospitalizations and ED visits, improving quality gap closure, and helping patients complete their self-identified clinical and social goals. These are the outcomes our partners hold us accountable for, and it’s how we evaluate whether we’re making progress toward our goal of achieving health equity in our communities. 

–Rajaie Batniji, Co-Founder and CEO

Equity in Organizational Culture and Practices

Upon Waymark’s founding, we designated the organization as a public benefit company (PBC) –an organization with the express goal of creating a positive social and environmental impact. We wanted to embed within our foundational documents our commitment to building and scaling a financially sustainable business that is accountable for improving health outcomes for patients receiving Medicaid benefits. Regardless of who is leading our organization, this PBC designation ensures that Waymark as a company will always be held accountable for its mission.

Our community health worker (CHW)-led model hinges on a focus in community-based care. Our CHWs, all hired and trained from the communities we serve, are benefitted employees with grants of equity in Waymark, not contractors. We’re seeking to provide a financially sustainable path for our team members, and offering our care team members the ability to care for their neighbors while retaining equity in our company is the best way we’ve found to do that. We listen humbly to our care delivery team members and the communities we serve and build products and technology to address the specific needs and care gaps they’ve identified.

Looking forward to 2025 and beyond, we’re going to continue thinking about ways in which we can continue to support equity for our employees; at the start of this year, we launched a 401k contribution program that supports all employees’ retirement savings no matter where they land on the financial spectrum. That’s another way we’ve found to economically invest in the communities we serve and the people doing this work— which will remain a priority for our organization as we grow and expand into new markets. 

-Afia Asamoah, Co-Founder and Head of Legal and People