Massachusetts Community-Based Organization Perspectives on Medicaid Redesign

Byhoff, Elena; Taylor, Lauren A.

doi:10.1016/j.amepre.2019.07.017

Cited by 24 publications

(22 citation statements)

References 16 publications

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“…Our findings are consistent with the limited literature suggesting CBOs are optimistic about partnering with healthcare systems to better serve the clinical and social needs of vulnerable populations [ 25 ]. Participants placed value on WPC-LA’s ability to expand networks and capacity for clients, agencies, and health system collaborators.…”

Section: Discussionsupporting

confidence: 91%

Community-based organizations’ perspectives on improving health and social service integration

et al. 2021

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Background Collaborations between health systems and community-based organizations (CBOs) are increasingly common mechanisms to address the unmet health-related social needs of high-risk populations. However, there is limited evidence on how to develop, manage, and sustain these partnerships, and implementation rarely incorporates perspectives of community social service organizations. To address these gaps, we elicited CBOs’ perspectives on service delivery for clients, the impact of the Whole Person Care-Los Angeles (WPC-LA) initiative to integrate health and social care, and their suggestions for improving health system partnerships. Methods Using stakeholder engaged principles and a qualitative Rapid Assessment Process, we conducted brief surveys and in-depth semi-structured interviews with 65 key informants from 36 CBOs working with WPC-LA. Results Major themes identified by CBOs included: 1) the importance of a holistic, client-centered, continuously engaged approach that is reliant on regional partnerships; 2) benefits of WPC-LA expanding capacity and networks; 3) concerns about communication and redundancy hindering WPC-LA; and 4) a need for more equitable partnerships incorporating their approaches. Conclusions CBOs value opportunities for integration with health systems, bring critical expertise to these partnerships, and seek to strengthen cross-sector collaborations. Early, equitable, and inclusive participation in the development and implementation of these partnerships may enhance their effectiveness, but requires policy that prioritizes and incentivizes sustainable and mutually beneficial partnerships.

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Section: Discussionsupporting

confidence: 91%

Community-based organizations’ perspectives on improving health and social service integration

et al. 2021

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“…The CBOs are stretched thin and often working with limited staff and financial resources. These findings align with previous studies that highlighted CBOs concern about resources, as well as limited understanding of human services delivery on the part of health systems, as a deterrent to social need collaboration (Byhoff & Taylor, 2019; Petchel, Gelmon, & Goldberg, 2020). Making sure these organisations are included in high‐level conversations about the structure of clinical‐to‐community models to address social needs, in addition to thinking about innovative funding and support mechanisms, is critical to building strong and sustainable cross‐sector relationships.…”

Section: Discussionsupporting

confidence: 90%

“…Even in these communities where a great deal of attention to these issues is driving policy, funding and program change, it became evident that the systems in place are still new and evolving. Similar studies on cross‐sector strategies to address unmet social need have also noted the importance of aligning mission, outcomes and definitions as a strategy to improve collaborative efforts (Byhoff & Taylor, 2019; Petchel et al, 2020). In particular, we noted the lack of a strong connection between clinical providers and CBOs, a lack of common terms (SDOH versus whole person care) for building collaborative strategies, and a misalignment between roles, value and resource exchanges among organisations, further validating that much can be done to better align and integrate health and social services.…”

Section: Discussionmentioning

confidence: 91%

“…A key component of addressing unmet social needs is the development of a cross‐sector screening and referral infrastructure that integrates health and social services (Alley et al., 2016; Berkowitz et al, 2018; Butler, 2015; Fraze, Lewis, Rodriguez, & Fisher, 2016; Gottlieb, Wing, & Adler, 2017; Hogg & Varda, 2016; Rediger & Miles, 2018; Varda, Edwards, Ely, & Hogg Graham, forthcoming). However, noticeably absent from many high‐level conversations about the design and implementation of social needs strategies are the community‐based organisations (CBOs) typically responsible for addressing unmet social needs (Byhoff & Taylor, 2019). CBOs, typically non‐profits located in the communities they serve, provide a wide variety of services critical to ensuring health and well‐being.…”

Section: Introductionmentioning

confidence: 99%

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Exploring the capacity of community‐based organisations to absorb health system patient referrals for unmet social needs

Hogg-Graham

Edwards²,

Ely

et al. 2020

Health Soc Care Community

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This study examines the perspectives, resources, role and services provided by community‐based organisations (CBOs) in response to the integration of health and social services to address individual unmet social needs, as well as the impact on organisational carrying capacity related to the ability to receive referrals from health system partners. Mixed methods combining qualitative interviews with 24 organisations and Social Network Analysis with 75 organisations were completed in 2018 in two communities (Denton, TX and Sarasota, FL) with robust examples of health and social systems alignment. Findings suggest that while community organisations are embedded in robust cross‐sector networks, the potential increase in referrals from clinical settings is not something they are fully aware of, or prepared for, as evidenced by inadequate funding models, misalignment between capacity and capability, and a lack of coordination on screening and referral activities. Misalignment between clinical and CBO understanding of demand, needs and capacity present a potential risk in building strategies that integrate health and social services to address unmet social need. Failing to build a strong cross‐sector screening and referral infrastructure that considers CBO capacity from the start could undermine the goal of improving population health through the integration of clinical and social care.

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“…Given that social needs interventions often depend on coordination with social services organizations, it is important to identify how to avoid any potential negative impacts and how the health and social services sectors can best collaborate on social needs interventions. 43 Finally, some worry that the healthcare sector's focus on individual patient needs will divert attention and resources from more cost-effective community-based approaches, an important concern that would also benefit from focused research. 25,44 What Are the Impacts on Health Equity?…”

Section: Do Social Needs Interventions Have Negative Unintended Consementioning

confidence: 99%

Improving Social Needs Intervention Research: Key Questions for Advancing the Field

Fichtenberg

Alley

Mistry

2019

American Journal of Preventive Medicine

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Spurred by accumulated evidence documenting how social determinants of health shape health outcomes as well as the push for better value, the healthcare sector is embracing interventions that address patients' health-related social needs. An increasing number of healthcare organizations and payers are experimenting with strategies to identify needs and connect patients to resources that address identified needs with the goal of improving health outcomes, reducing avoidable utilization of costly health services, and improving health equity. Although many studies link social factors to health, relatively little published research exists about how the healthcare sector can effectively intervene to help identify and address social needs. This paper summarizes emerging evidence and identifies key areas where more research is needed to advance implementation and policy development. Although some healthcare-based social needs interventions have been shown to improve health and reduce avoidable utilization, important gaps remain in terms of comparative effectiveness and cost effectiveness of social needs intervention approaches. Additionally, the field would benefit from an increased understanding of mechanisms of action to maximize practitioners' ability to tailor interventions. More research is also needed to guard against unintended consequences and ensure these interventions reduce health inequities. Finally, implementation science research should identify supports and incentives for adoption of effective interventions. Focusing both public and private research efforts on these evidence gaps can help advance identification of interventions that maximize both health equity and healthcare value.

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Massachusetts Community-Based Organization Perspectives on Medicaid Redesign

Cited by 24 publications

References 16 publications

Community-based organizations’ perspectives on improving health and social service integration

Community-based organizations’ perspectives on improving health and social service integration

Exploring the capacity of community‐based organisations to absorb health system patient referrals for unmet social needs

Improving Social Needs Intervention Research: Key Questions for Advancing the Field

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