3 Key Takeaways from the Heartland Conference on Health Equity & Patient-Centered Care

The Heartland Conference on Health Equity and Patient-Centered Care brought together over 300 participants from across the Midwest to tackle the complex challenge of bridging urban and rural health equity. Three critical insights emerged that will reshape how organizations approach equity initiatives in today's political environment. 

1. Leadership as Foundation: Calibrating Heat, Not Just Raising It 

The conference's central message was clear: sustainable health equity requires distributed leadership, not just directives from the C-suite. The Friday keynote on "everyone as leaders" reinforced that effective leaders don't always "turn up the heat" on contentious issues; they calibrate it. Sometimes lowering the temperature creates space for dialogue, while other times maintaining pressure drives necessary change. 

This nuanced approach is particularly critical in today's political climate, where equity has become a four-letter word under the current administration. Leaders must navigate complex stakeholder relationships with both urgency and patience, recognizing that different communities require different engagement strategies. The most effective leaders are finding ways to continue this essential work by focusing on outcomes rather than terminology, emphasizing shared values like quality care and community health rather than politically charged language. 

Key insight: Organizations need leadership development beyond traditional hierarchies. Community health workers, frontline staff, and mid-level managers must be equipped to lead equity initiatives within their spheres of influence, creating resilience that top-down approaches lack. In challenging political times, distributed leadership ensures the work continues regardless of shifting rhetoric. 

2. Rebuilding Trust Through Listening and Shared Action 

One of the most striking observations was the acknowledged mistrust and misalignment of values between community-based organizations and health systems. This divide isn't merely philosophical; it impacts patient outcomes daily, particularly in rural communities where relationships are foundational to effective care delivery. The path forward requires intentional trust-building that goes beyond traditional stakeholder engagement. This means moving from consultation to co-creation, where community voices shape both problem definition and solution design. 

Key insight: Trust-building must be measured and sustained over time. Organizations should invest in structured listening processes that create space for difficult conversations about values, priorities, and past failures. The goal isn't consensus; it's authentic partnership. 

3. The Both/And Imperative: Policy + Proximity for Systems Change and Direct Impact 

Conference discussions reinforced that effective health equity work requires refusing false choices. This both/and approach is particularly relevant in today's resource-constrained environment, where organizations often feel forced to choose between advocacy and service delivery, between addressing immediate needs and long-term transformation. 

The reality is that sustainable equity requires policy + proximity: simultaneous action at multiple levels where policy advocacy is paired with direct services, systems change connected to community engagement, and infrastructure development alongside individual support. Organizations that excel at health equity find ways to strengthen the connections between these approaches rather than treating them as competing priorities. 

This isn't just the right thing to do; it's smart business. The conference highlighted that there's clear ROI in health equity models focused on improved outcomes and cost reduction. Bad care causes harm, and it's also bad for organizations' bottom lines. Knowing where you have gaps and where you're delivering excellent care is foundational for success in value-based care arrangements. Organizations can't afford to ignore disparities when their financial sustainability depends on population health outcomes. 

Key insight: Develop strategies that explicitly connect advocacy efforts to direct impact. Ensure that policy work is informed by frontline experience and that community services demonstrate the need for systems change. Measure both equity outcomes and financial performance; it's a "yes and" situation where doing good aligns with doing well. 

Moving Forward 

The Heartland Conference demonstrated that sustainable health equity requires more than good intentions or additional funding; it demands a fundamental shift in approach. In today's political environment, organizations need distributed and calibrated leadership, trust built through proximity and policy alignment, and intervention design that addresses both systemic barriers and immediate community needs. 

These insights provide a roadmap for creating lasting change: invest in leadership at all levels, prioritize trust-building through authentic listening and shared action, and design interventions that bridge the gap between policy and practice. The path forward requires both strategic thinking and relational commitment, a both/and approach that the heartland understands well. 

At Coral, we know that sustainable equity in value-based care isn’t achieved through incremental tweaks; it requires systems change. We’ve partnered with states, payers, and providers to align policy with practice, integrate financing with frontline experience, and design models that improve outcomes while ensuring long-term sustainability. If your organization is ready to take the next step towards systems change in value-based care, reach out to Coral Director Kate Freeman.