Spring 2018 Generations

Fundamentals of Community-Based Managed Care: A Field Guide

page and has input into the development and implementation of the projects. This means CBO leadership and staff, direct service providers, and the patients they serve are informed about the newmethods of care and delivery, are engaged in the development, implementation, and evaluation of partnerships, and are working toward the same goals. State Medicaid programs can help accom- plish this by including CBO representation on Medicaid advisory committees and workgroups and promoting models of care delivery that en­ courage patients to work in partnership with their healthcare providers and CBOs to meet healthcare goals. CBOs can be active in community education and outreach, and collect feedback on the partner- ship’s success, to ensure the uptake and success of services offered through the partnership. Conclusion The healthcare system is changing rapidly and new models of care that address the social and economic determinants of health are crucial for ensuring that there is improved care for vulner- able populations who face the biggest disparities in health outcomes. CBOs can play an important role by partnering with health systems through newMedicaid fnancing mechanisms. If CBOs have the knowledge and tools necessary to build a successful partnership, and state Medicaid pro- grams actively engage CBOs in the development

‘One early adopter health system encouraged other health systems to join the partnership.’ comes in communities across the country. While there is real opportunity however, there also is uncertainty. Recent proposals in Congress to drastically cut spending in the Medicaid program through block grants or per capita caps put the funding and infrastructure needed to support these innovative partnerships at risk (Rosenbaum et al., 2017). As CBOs begin to move into the healthcare space with more fre- quency, they will need to stay attuned to federal healthcare activities and may need to become more vocal advocates for the health programs that are becoming increasingly integral to their work and mission. Danielle Garrett, M.P.Aff., is strategic policy manager at the Center for Consumer Engagement in Health Innovation, in its Washington, D.C., office. She can be contacted at dgarrett@communitycatalyst.org. Ann Hwang, M.D., is director of the Center for Consumer Engagement in Health Innovation at Community Catalyst in Boston, Massachusetts. and implementation of these new models of care, there is real opportunity to improve health out-

References Kozick, D. 2017. Collaborating to Reduce Hospital Readmissions for Older Adults with Complex Needs: Eastern Virginia Care Transi- tions Partnership. Partnership for Healthy Outcomes. goo.gl/fNByb3. Retrieved November 13, 2017. Lloyd, J., and Heflin, K. 2016. “Massachusetts’ Medicaid ACO Makes a Unique Commitment to Addressing Social Determinants of Health.” Center for Health Care Strategies. goo.gl/1BWzAe. Retrieved November 13, 2017.

Musumeci, M. 2014. “Key Themes in Capitated Medicaid Managed Long-term Services and Supports Waivers.” Kaiser Family Founda- tion. goo.gl/3463VC. Retrieved November 13, 2017. Rosenbaum, S., et.al. 2017. “How Will Repealing the ACA Affect Medicaid? Impact on Health Care Coverage, Delivery, and Payment.” The Commonwealth Fund. goo.gl/xNgRVd. Retrieved Nov­ ember 27, 2017.

Substance Abuse and Mental Health Services Administration. 2012. Behavioral Health Homes for People with Mental Health & Sub- stance Use Conditions: The Core Clinical Features. goo.gl/AYJUvX. Retrieved November 13, 2017. Wiitala, K., and Hwang, A. 2017. “Perspectives on How to Engage Consumers in Health System Transformation.” Journal of Ambu- latory Care Medicine (40)4: 283–6.

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